Re: REVIEW - Amitriptyline in the treatment of fibromyalgia: a systematic review of its efficacy

[Guest guest]

Thank you for this .

I have been on amitriptyline since first diagnosed with fibromyalgia

several years ago. Maybe that's why it doesn't work for me anymore. I

have had chronic insomnia until I got Ambien CR instead.

Debbie L

>

> Rheumatology Advance Access originally published online on August

12, 2008

> Rheumatology 2008 47(12):1741-1746; doi:10.1093/rheumatology/ken317

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> REVIEWS

>

>

> Amitriptyline in the treatment of fibromyalgia: a systematic review

of

> its efficacy

>

>>

> The objective of this study was to assess the efficacy and safety of

> amitriptyline as a treatment of FM. A comprehensive computerized

> search in Medline (Pubmed), EMBASE and The Cochrane Library was

> performed. Randomized controlled trials (RCTs) comparing

amitriptyline

> vs placebo in adult patients suffering from FM were identified, the

> methodological quality was assessed and the results of the main

> outcomes were evaluated. Ten RCTs were identified. Large clinical

> variability and statistical heterogeneity precluded quantitative

> meta-analysis. Overall, the study quality was moderate to high.

> Amitriptyline 25 mg/day (six RCTs) demonstrated a therapeutic

response

> compared with placebo in the domains of pain, sleep, fatigue and

> overall patient and investigator impression. This benefit was

> generally seen at 6–8 weeks of treatment but no effect was noted at

12

> weeks. Amitriptyline 50 mg/day (four RCTs) did not demonstrate a

> therapeutic effect compared with placebo. Neither dose of

> amitriptyline had an effect on tender points count. No clear

> statements on adverse events with amitriptyline can be made due to

> inconsistencies in data among the studies. A definitive clinical

> recommendation regarding the efficacy of amitriptyline for FM

symptoms

> cannot be made. There is some evidence to support the short-term

> efficacy of amitriptyline 25 mg/day in FM. There is no evidence to

> support the efficacy of amitriptyline at higher doses or for periods

> >8 weeks. More stringent RCTs with longer follow-up periods are

> required to determine the long-term efficacy and safety of the

> amitriptyline and define its role in the multidisciplinary

management

> of FM.

>

>

>

http://rheumatology.oxfordjournals.org/cgi/content/abstract/47/12/1741

?etoc

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>

>

> Not an MD

>

[Guest guest]

Hi ,

When I see my rheumy Dec 9, I will tell him I have been off the

amitriptyline for almost a month now. Hopefully he will supggest

something different. My pcp gave me the Ambien but doesn't want me to

stay on it since it's addicting. I see her Jan 6.

Debbie L

>

> Debbie,

>

> Maybe. I think I would ask about it at your next appointment.

>

>

>

> Not an MD

>

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>