Newer Antidepressants with Pregabalin for Fibromyalgia Syndrome
Fibromyalgia syndrome (FMS) is a form of fibromyalgia where pain and stiffness occurs in muscles, tendons, and ligaments throughout the body, accompanied by other generalized symptoms such as fatigue, sleep disruption or unrefreshing sleep, mood disorder, and cognitive difficulties such as poor memory or mental fogginess.
Fibromyalgia is often treated in a multifaceted fashion, using both medications and non-medication methods to improve symptoms. Low doses of antidepressant medications are often used to treat fibromyalgia. Antidepressants can improve sleep and may help with the pain. In higher doses, they can also be used to treat mood disorders in people who develop them along with their fibromyalgia.
To investigate the combined use of pregabalin plus paroxetine for the management of fibromyalgia, a randomized study was conducted. This group was compared with the other group who have given the combination of pregabalin plus either amitriptyline or venlafaxine.
Total 75 female subjects were diagnosed with fibromyalgia and in receipt of pregabalin (75 mg/day) were given randomly for the comparison with amitriptyline (25 mg/day), venlafaxine (75 mg/day) or paroxetine (25 mg/day). The assessment was done on the basis of factors like life satisfaction, mood, sleep quality, fatigue, medication tolerability and risk factors.
When both the groups compared with pregabalin plus amitriptyline or venlafaxine, the combined use of pregabalin plus paroxetine in fibromyalgia patients resulted in significantly lower SSS-8 and CESDS scores from 18 and 10 weeks, when the medications were started. Whereas, higher medication tolerability resulted in improved life satisfaction, mood and sleep quality after the observation, but with few adverse events of dry mouth and elevated blood pressure. While in the venlafaxine group, medications were terminated due to poor tolerability, whereas, in amitriptyline group drowsiness, dizziness, blurred vision, abnormal taste, hunger, hallucination, urination problems and sexual dysfunction were observed.
On completion of the comparison, it was observed that the combined use of pregabalin plus paroxetine offered an effective method with increased tolerability. Somatic and depressive symptoms of fibromyalgia were also reduced and it was also observed that the quality of life was also enhanced in the affected individuals.