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Amitriptyline for the treatment of fibromyalgia: a comprehensive review.

Abstract

Fibromyalgia is characterized by chronic generalized pain accompanied by a wide range of clinical manifestations. Most clinical practice guidelines recommend multidisciplinary treatment using a combination of pharmacological and non-pharmacological therapies. The tricyclic antidepressant amitriptyline has been most thoroughly studied in fibromyalgia. Amitriptyline has been evaluated in placebo-controlled studies, and it has served as an active comparator to other therapeutic interventions in the treatment of fibromyalgia. In addition, several systematic reviews and meta-analyses have evaluated its efficacy and safety for the treatment of fibromyalgia. Data from individual studies as well as from systematic reviews indicate that low doses (10-75 mg/day) of amitriptyline are effective for the treatment of fibromyalgia and, despite the limited quality of the data, they do not seem to be associated with relevant tolerability or safety issues. Consistent with some clinical guidelines, we believe amitriptyline in low doses should be considered a first-line drug for the treatment of fibromyalgia.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    a Universidad de Granada, Instituto de Neurociencias, Granada, Spain.

    ,

    a Universidad de Granada, Instituto de Neurociencias, Granada, Spain.

    Source

    Expert review of neurotherapeutics 15:10 2015 Oct pg 1123-50

    MeSH

    Amitriptyline
    Antidepressive Agents, Tricyclic
    Fibromyalgia
    Humans
    Randomized Controlled Trials as Topic

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    26395929

    Citation

    Rico-Villademoros, Fernando, et al. "Amitriptyline for the Treatment of Fibromyalgia: a Comprehensive Review." Expert Review of Neurotherapeutics, vol. 15, no. 10, 2015, pp. 1123-50.
    Rico-Villademoros F, Slim M, Calandre EP. Amitriptyline for the treatment of fibromyalgia: a comprehensive review. Expert Rev Neurother. 2015;15(10):1123-50.
    Rico-Villademoros, F., Slim, M., & Calandre, E. P. (2015). Amitriptyline for the treatment of fibromyalgia: a comprehensive review. Expert Review of Neurotherapeutics, 15(10), pp. 1123-50. doi:10.1586/14737175.2015.1091726.
    Rico-Villademoros F, Slim M, Calandre EP. Amitriptyline for the Treatment of Fibromyalgia: a Comprehensive Review. Expert Rev Neurother. 2015;15(10):1123-50. PubMed PMID: 26395929.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Amitriptyline for the treatment of fibromyalgia: a comprehensive review. AU - Rico-Villademoros,Fernando, AU - Slim,Mahmoud, AU - Calandre,Elena P, Y1 - 2015/09/22/ PY - 2015/9/24/entrez PY - 2015/9/24/pubmed PY - 2016/5/10/medline KW - amitriptyline KW - antidepressants KW - clinical practice guidelines KW - fibromyalgia management KW - randomized clinical trials KW - review KW - systematic reviews SP - 1123 EP - 50 JF - Expert review of neurotherapeutics JO - Expert Rev Neurother VL - 15 IS - 10 N2 - Fibromyalgia is characterized by chronic generalized pain accompanied by a wide range of clinical manifestations. Most clinical practice guidelines recommend multidisciplinary treatment using a combination of pharmacological and non-pharmacological therapies. The tricyclic antidepressant amitriptyline has been most thoroughly studied in fibromyalgia. Amitriptyline has been evaluated in placebo-controlled studies, and it has served as an active comparator to other therapeutic interventions in the treatment of fibromyalgia. In addition, several systematic reviews and meta-analyses have evaluated its efficacy and safety for the treatment of fibromyalgia. Data from individual studies as well as from systematic reviews indicate that low doses (10-75 mg/day) of amitriptyline are effective for the treatment of fibromyalgia and, despite the limited quality of the data, they do not seem to be associated with relevant tolerability or safety issues. Consistent with some clinical guidelines, we believe amitriptyline in low doses should be considered a first-line drug for the treatment of fibromyalgia. SN - 1744-8360 UR - https://www.unboundmedicine.com/medline/citation/26395929/full_citation L2 - http://www.tandfonline.com/doi/full/10.1586/14737175.2015.1091726 DB - PRIME DP - Unbound Medicine ER -