RESEARCH ARTICLE
The Use of Antidepressants in the Long-Term Treatment Should not Improve the Impact of Fibromyalgia on Quality of Life
MG Carta1, *, V Ruggiero2, F Sancassiani1, F Cutrano1, AR Manca1, M Peri3, A Fais4, E Cacace2
Article Information
Identifiers and Pagination:
Year: 2013Volume: 9
First Page: 120
Last Page: 124
Publisher ID: CPEMH-9-120
DOI: 10.2174/1745017901309010120
Article History:
Received Date: 13/4/2013Revision Received Date: 18/5/2013
Acceptance Date: 19/5/2013
Electronic publication date: 12/7/2013
Collection year: 2013

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.
Abstract
Background:
Antidepressant (AD) drugs are effective in the short term treatment of fibromyalgia (FM). It may be useful to study the long-term impact of AD on patients with FM.
Methods:
One-year follow-up study on 23 females with FM divided into groups on AD (ADg-N=7), and not taking AD (NADg-N=11). Evaluation at t1 and at the end (t2) with the Fibromyalgia Impact Questionnaire (FIQ); at t2 with: SCID-IV; Mood Disorder Questionnaire (MDQ); Short Form-12; Hamilton Depression Rating Scale (HAM-D); Functioning Assessment Short Test (FAST)
Results:
After a year the AD group showed a worst impact of the disease by FIQ (p=0.017), worsened quality of life by SF-12 (p<0.01), and disability linked to bipolar symptoms by FAST (p=0.05). About 40% of the sample was screened positive at MDQ without difference in the two groups. The patients who recovered from a depressive episode did not differ between ADg and NADg (20% vs 33.3%), and were fewer than expected from the literature (40-60%). The HAM-D score at the end of the trial was worse in the ADg (p<0.03).
Limitations:
Observational research on few patients, not specifically designed to test the hypothesis. The results have a heuristic value only.
Discussion:
The results should be read in the light of the high prevalence of patients screened positive for Bipolar Disorders and of the well-known poor response of the mood symptoms to antidepressants in Bipolar Depression. The deterioration in the long-term management of FM patients following AD treatments suggests the need for new and robust studies.