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Antidepressants May Be Useful in Treating Fibromyalgia

Meta-analysis supports use of amitriptyline, duloxetine for pain and sleep problems

TUESDAY, Jan. 13 (HealthDay News) -- Antidepressants appear to offer some benefits in treating pain, sleep problems and depression, and for improving health-related quality of life in people with fibromyalgia syndrome, according to the results of a meta-analysis published in the Jan. 14 issue of the Journal of the American Medical Association.

Winfried Hauser, M.D., of the Klinikum Saarbrucken in Germany, and colleagues included 18 randomized controlled trials with 1,427 participants in their analysis. The authors found strong evidence for reduced pain, fatigue and depressed mood, and improved sleep associated with antidepressants. However, they write that the effect of antidepressant therapy was "negligible" for fatigue and small for the other outcomes.

However, amitriptyline showed large effect sizes on reducing pain and sleep disturbances, the report indicates, and duloxetine showed strong evidence for efficacy in reducing pain and sleep disturbances and improving depressed mood, though these effect sizes were small.

"Short-term usage of amitriptyline and duloxetine can be considered for the treatment of pain and sleep disturbances in fibromyalgia syndrome," the authors conclude. "Before treatment is initiated, concomitant diseases related to potential adverse effects of the drugs and patients' preferences should be considered. Goals of pharmacological therapy should be defined (no cure, but possible symptom reduction). Since evidence for a long-term effect of antidepressants in fibromyalgia syndrome is still lacking, their effects should be reevaluated at regular intervals to determine whether benefits outweigh adverse effects."

Several of the study authors disclosed financial relationships with a number of pharmaceutical companies.

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