An Evaluation of Antidepressants in Rheumatic Pain Conditions

In a randomized, double-blind, parallel study, fluoxetine and amitriptyline were compared with placebo in the treatment of chronic rheumatic pain. A total of 59 patients were evaluated during 4 wk of treatment and received 20 mg fluoxetine, 25 mg amitriptyline, or placebo daily. Pain intensity, pain relief, vital variables, and global evaluation were used to assess efficacy. To evaluate safety variables, the incidence of side effects was noted. Both amitriptyline and fluoxetine significantly reduced pain intensity compared with placebo. Similarly, pain relief was greater with both amitriptyline and fluoxetine than with placebo. At the end of the fourth week, fluoxetine was superior in efficacy to amitriptyline. The incidence of adverse effects was significantly greater with amitriptyline; dryness of the mouth was the most predominant side effect. We conclude that fluoxetine is an effective analgesic with fewer side effects. (Anesth Analg 1996;83:371-5)

[1]  C. Hummel,et al.  A comparison of the antinociceptive effects of imipramine, tramadol and anpirtoline. , 1994, British journal of clinical pharmacology.

[2]  F. Cantini,et al.  [Fluoxetin combined with cyclobenzaprine in the treatment of fibromyalgia]. , 1994, Minerva medica.

[3]  D. Carroll,et al.  Dose‐response for analgesic effect of amitriptyline in chronic pain , 1993, Anaesthesia.

[4]  R Dubner,et al.  Effects of desipramine, amitriptyline, and fluoxetine on pain in diabetic neuropathy. , 1992, The New England journal of medicine.

[5]  Patrick Onghena,et al.  Antidepressant-induced analgesia in chronic non-malignant pain: a meta-analysis of 39 placebo-controlled studies , 1992, Pain.

[6]  K. Brøsen,et al.  The selective serotonin reuptake inhibitor paroxetine is effective in the treatment of diabetic neuropathy symptoms , 1990, Pain.

[7]  I. Egbunike,et al.  Antidepressants in the Management of Chronic Pain Syndromes , 1990, Pharmacotherapy.

[8]  K. Kr.  Antidepressants in chronic pain syndromes. , 1989 .

[9]  P. Turner,et al.  Cardiovascular (ECG and systolic time intervals) and anticholinergic effects of repeated doses of femoxetine--a comparison with amitriptyline and placebo in healthy men. , 1989, British journal of clinical pharmacology.

[10]  N. Beck,et al.  Antidepressant analgesia in rheumatoid arthritis. , 1988, The Journal of rheumatology.

[11]  D. E. Nelson.  A practical approach to workers' compensation. , 1988, American family physician.

[12]  L. Boccassini,et al.  Double-Blind Study of Dothiepin versus Placebo in the Treatment of Primary Fibromyalgia Syndrome , 1987, The Journal of international medical research.

[13]  C. Bowden,et al.  Fluoxetine: A Serotonin‐specific, Second‐generation Antidepressant , 1987, Pharmacotherapy.

[14]  C. Feinmann.  Pain relief by antidepressants: Possible modes of action , 1985, Pain.

[15]  E. Richelson,et al.  Antagonism by antidepressants of neurotransmitter receptors of normal human brain in vitro. , 1984, The Journal of pharmacology and experimental therapeutics.

[16]  A. Fro̸land,et al.  Imipramine treatment of painful diabetic neuropathy. , 1984, JAMA.

[17]  H. Merskey,et al.  Amitriptyline versus placebo in post-herpetic neuralgia , 1981, PAIN.

[18]  R. Messing,et al.  Serotonin-containing neurons: their possible role in pain and analgesia , 1977, Pain.

[19]  J. Wang.  Antinociceptive Effect of Intrathecally Administered Serotonin , 1977, Anesthesiology.

[20]  G. Hertting,et al.  FLUVOXAMINE, A SPECIFIC 5‐HYDROXYTRYPTAMINE UPTAKE INHIBITOR , 1977, British journal of pharmacology.

[21]  K. Krishnan,et al.  Antidepressants in chronic pain syndromes. , 1989, American family physician.

[22]  B. Ahlberg,et al.  Femoxetine in the treatment of patients with depressive illness–a randomized comparison with amitriptyline , 1982 .