Fluvoxamine versus amitriptyline in the treatment of fibromyalgia

Abstract

In this study, fluvoxamine, a relatively new selected serotonin reuptake inhibitor, was compared with amitriptyline in a double-blind, crossover study in 15 hospital outpatients suffering from fibromyalgia syndrome. The study was approved by the Ethics Committee of Ege University Hospital and informed consent was obtained from each patient. Exclusion criteria for the investigation were presence of psychiatric diagnosis, rheumatic disease and other systemic co-existing disease. Flowing a 2 week wash-out period for analgesic and/or adjuvan drugs, patients randomly received 25 mg amitriptyline or 50 mg fluvoxamine for a period of 4-weeks. After a 2-week wash-out period, patients were re-evaluated before receiving the second drug for another 4 weeks. Assesment of efficacy was made on entry and at 2 week intervals for each drug using visual analog scale (VAS) scores, number of tender points, presence and degree of minor criteria symptoms. Analysis of variance and Wilcoxon matched pairs were used for the statistical comparison of the data. At the end of the trial, there was a significant reduction in VAS scores, number of tender points as well as the severity of the minor criteria symptoms. Overall there were no significant differences in terms of efficacy between the two drugs except anxiety. Anxiety scores in fluvoxamine group were significantly lower than the amitriptyline group. It was concluded that fluvoxamine in an effective, well-tolerated alternative to amitriptyline in the treatment of fibromyalgia syndrome.