Psychological Factors Affecting Response to Antidepressant Drugs in Fibromyalgia
Background The use of antidepressant drugs in fibromyalgia is extensive despite small evidence of the real impact in the clinical practice setting. This study was aimed to evaluate the long-term efficiency of antidepressant treatment in fibromyalgia and the role of psychosocial factors in treatment...
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| Veröffentlicht in: | Psychosomatics (Washington, D.C.) D.C.), 2011-05, Vol.52 (3), p.237-244 |
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| creator | Díaz-Marsá, Marina, M.D Palomares, Nerea, Ph.D Morón, M. Dolores, M.D Tajima, Kazuhiro, M.D Fuentes, Manuel E., M.D López-Ibor, Juan José, M.D Carrasco, José Luis, M.D |
| description | Background The use of antidepressant drugs in fibromyalgia is extensive despite small evidence of the real impact in the clinical practice setting. This study was aimed to evaluate the long-term efficiency of antidepressant treatment in fibromyalgia and the role of psychosocial factors in treatment response. Methods A total of 102 consecutive patients with fibromyalgia from primary health care centers were studied with psychopathological and psychological assessment interviews and questionnaires. Sustained release venlafaxine was added to previous treatments in flexible doses from 150 to 300 mg daily for a 6-month period. Efficacy measures included the Clinical Global Impression (CGI) scale (patient and clinician versions) and the Fibromyalgia Impact Questionnaire (FIQ) score reduction. Results At 6 months, 48% patients were considered responders to treatment (CGI change score 1 or 2) and 23.5% had a mild response. Of note, 57.8% had less fatigue and 31.4% had less pain. The proportion of responders was greater in the group with major depression (65%) than in those without depression (45%), but the difference did not reach statistical significance. However, the reduction of FIQ scores was significantly greater in depressed (21.1; IQR: 1.4–42.0) than in non-depressed patients (41.4; IQR: 23.6–52.6) (P < 0.05). FIQ score reduction was significantly smaller in patients taking concomitant opiate treatment (P < 0.01) and in patients seeking incapacitation (P < 0.01). Conclusion Antidepressant treatment in fibromyalgia was effective in patients with and without major depression, but the functional response was greater in depressed patients. Treatment response to antidepressants might be significantly influenced by attitudinal and psychosocial factors of the disease. |
| doi_str_mv | 10.1016/j.psym.2010.12.014 |
| format | Article |
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Dolores, M.D ; Tajima, Kazuhiro, M.D ; Fuentes, Manuel E., M.D ; López-Ibor, Juan José, M.D ; Carrasco, José Luis, M.D</creator><creatorcontrib>Díaz-Marsá, Marina, M.D ; Palomares, Nerea, Ph.D ; Morón, M. Dolores, M.D ; Tajima, Kazuhiro, M.D ; Fuentes, Manuel E., M.D ; López-Ibor, Juan José, M.D ; Carrasco, José Luis, M.D</creatorcontrib><description>Background The use of antidepressant drugs in fibromyalgia is extensive despite small evidence of the real impact in the clinical practice setting. This study was aimed to evaluate the long-term efficiency of antidepressant treatment in fibromyalgia and the role of psychosocial factors in treatment response. Methods A total of 102 consecutive patients with fibromyalgia from primary health care centers were studied with psychopathological and psychological assessment interviews and questionnaires. Sustained release venlafaxine was added to previous treatments in flexible doses from 150 to 300 mg daily for a 6-month period. Efficacy measures included the Clinical Global Impression (CGI) scale (patient and clinician versions) and the Fibromyalgia Impact Questionnaire (FIQ) score reduction. Results At 6 months, 48% patients were considered responders to treatment (CGI change score 1 or 2) and 23.5% had a mild response. Of note, 57.8% had less fatigue and 31.4% had less pain. The proportion of responders was greater in the group with major depression (65%) than in those without depression (45%), but the difference did not reach statistical significance. However, the reduction of FIQ scores was significantly greater in depressed (21.1; IQR: 1.4–42.0) than in non-depressed patients (41.4; IQR: 23.6–52.6) (P < 0.05). FIQ score reduction was significantly smaller in patients taking concomitant opiate treatment (P < 0.01) and in patients seeking incapacitation (P < 0.01). Conclusion Antidepressant treatment in fibromyalgia was effective in patients with and without major depression, but the functional response was greater in depressed patients. Treatment response to antidepressants might be significantly influenced by attitudinal and psychosocial factors of the disease.</description><identifier>ISSN: 0033-3182</identifier><identifier>EISSN: 1545-7206</identifier><identifier>DOI: 10.1016/j.psym.2010.12.014</identifier><identifier>PMID: 21565595</identifier><language>eng</language><publisher>Arlington, VA: Elsevier Inc</publisher><subject>Adult ; Antidepressive Agents, Second-Generation - administration & dosage ; Antidepressive Agents, Second-Generation - therapeutic use ; Biological and medical sciences ; Cyclohexanols - administration & dosage ; Cyclohexanols - therapeutic use ; Delayed-Action Preparations ; Depressive Disorder, Major - complications ; Depressive Disorder, Major - drug therapy ; Female ; Humans ; Internal Medicine ; Interview, Psychological ; Leiomyoma - complications ; Leiomyoma - drug therapy ; Leiomyoma - psychology ; Male ; Medical sciences ; Neuropharmacology ; Pharmacology. Drug treatments ; Psychiatric Status Rating Scales ; Psychiatry ; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer ; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease) ; Psychology. Psychoanalysis. Psychiatry ; Psychopharmacology ; Surveys and Questionnaires ; Treatment Outcome ; Venlafaxine Hydrochloride</subject><ispartof>Psychosomatics (Washington, D.C.), 2011-05, Vol.52 (3), p.237-244</ispartof><rights>The Academy of Psychosomatic Medicine</rights><rights>2011 The Academy of Psychosomatic Medicine</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.</rights><rights>Copyright American Psychiatric Publishing, Inc. May/Jun 2011</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c511t-e41a76dd338f649399d1ce5defed5a22c093f50690cc11c7e3bb833417908a673</citedby><cites>FETCH-LOGICAL-c511t-e41a76dd338f649399d1ce5defed5a22c093f50690cc11c7e3bb833417908a673</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S003331821000037X$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24207429$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21565595$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Díaz-Marsá, Marina, M.D</creatorcontrib><creatorcontrib>Palomares, Nerea, Ph.D</creatorcontrib><creatorcontrib>Morón, M. Dolores, M.D</creatorcontrib><creatorcontrib>Tajima, Kazuhiro, M.D</creatorcontrib><creatorcontrib>Fuentes, Manuel E., M.D</creatorcontrib><creatorcontrib>López-Ibor, Juan José, M.D</creatorcontrib><creatorcontrib>Carrasco, José Luis, M.D</creatorcontrib><title>Psychological Factors Affecting Response to Antidepressant Drugs in Fibromyalgia</title><title>Psychosomatics (Washington, D.C.)</title><addtitle>Psychosomatics</addtitle><description>Background The use of antidepressant drugs in fibromyalgia is extensive despite small evidence of the real impact in the clinical practice setting. This study was aimed to evaluate the long-term efficiency of antidepressant treatment in fibromyalgia and the role of psychosocial factors in treatment response. Methods A total of 102 consecutive patients with fibromyalgia from primary health care centers were studied with psychopathological and psychological assessment interviews and questionnaires. Sustained release venlafaxine was added to previous treatments in flexible doses from 150 to 300 mg daily for a 6-month period. Efficacy measures included the Clinical Global Impression (CGI) scale (patient and clinician versions) and the Fibromyalgia Impact Questionnaire (FIQ) score reduction. Results At 6 months, 48% patients were considered responders to treatment (CGI change score 1 or 2) and 23.5% had a mild response. Of note, 57.8% had less fatigue and 31.4% had less pain. The proportion of responders was greater in the group with major depression (65%) than in those without depression (45%), but the difference did not reach statistical significance. However, the reduction of FIQ scores was significantly greater in depressed (21.1; IQR: 1.4–42.0) than in non-depressed patients (41.4; IQR: 23.6–52.6) (P < 0.05). FIQ score reduction was significantly smaller in patients taking concomitant opiate treatment (P < 0.01) and in patients seeking incapacitation (P < 0.01). Conclusion Antidepressant treatment in fibromyalgia was effective in patients with and without major depression, but the functional response was greater in depressed patients. Treatment response to antidepressants might be significantly influenced by attitudinal and psychosocial factors of the disease.</description><subject>Adult</subject><subject>Antidepressive Agents, Second-Generation - administration & dosage</subject><subject>Antidepressive Agents, Second-Generation - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Cyclohexanols - administration & dosage</subject><subject>Cyclohexanols - therapeutic use</subject><subject>Delayed-Action Preparations</subject><subject>Depressive Disorder, Major - complications</subject><subject>Depressive Disorder, Major - drug therapy</subject><subject>Female</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Interview, Psychological</subject><subject>Leiomyoma - complications</subject><subject>Leiomyoma - drug therapy</subject><subject>Leiomyoma - psychology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Neuropharmacology</subject><subject>Pharmacology. 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Dolores, M.D ; Tajima, Kazuhiro, M.D ; Fuentes, Manuel E., M.D ; López-Ibor, Juan José, M.D ; Carrasco, José Luis, M.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c511t-e41a76dd338f649399d1ce5defed5a22c093f50690cc11c7e3bb833417908a673</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Antidepressive Agents, Second-Generation - administration & dosage</topic><topic>Antidepressive Agents, Second-Generation - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Cyclohexanols - administration & dosage</topic><topic>Cyclohexanols - therapeutic use</topic><topic>Delayed-Action Preparations</topic><topic>Depressive Disorder, Major - complications</topic><topic>Depressive Disorder, Major - drug therapy</topic><topic>Female</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Interview, Psychological</topic><topic>Leiomyoma - complications</topic><topic>Leiomyoma - drug therapy</topic><topic>Leiomyoma - psychology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Neuropharmacology</topic><topic>Pharmacology. Drug treatments</topic><topic>Psychiatric Status Rating Scales</topic><topic>Psychiatry</topic><topic>Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer</topic><topic>Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease)</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopharmacology</topic><topic>Surveys and Questionnaires</topic><topic>Treatment Outcome</topic><topic>Venlafaxine Hydrochloride</topic><toplevel>online_resources</toplevel><creatorcontrib>Díaz-Marsá, Marina, M.D</creatorcontrib><creatorcontrib>Palomares, Nerea, Ph.D</creatorcontrib><creatorcontrib>Morón, M. Dolores, M.D</creatorcontrib><creatorcontrib>Tajima, Kazuhiro, M.D</creatorcontrib><creatorcontrib>Fuentes, Manuel E., M.D</creatorcontrib><creatorcontrib>López-Ibor, Juan José, M.D</creatorcontrib><creatorcontrib>Carrasco, José Luis, M.D</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>Psychosomatics (Washington, D.C.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Díaz-Marsá, Marina, M.D</au><au>Palomares, Nerea, Ph.D</au><au>Morón, M. Dolores, M.D</au><au>Tajima, Kazuhiro, M.D</au><au>Fuentes, Manuel E., M.D</au><au>López-Ibor, Juan José, M.D</au><au>Carrasco, José Luis, M.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Psychological Factors Affecting Response to Antidepressant Drugs in Fibromyalgia</atitle><jtitle>Psychosomatics (Washington, D.C.)</jtitle><addtitle>Psychosomatics</addtitle><date>2011-05-01</date><risdate>2011</risdate><volume>52</volume><issue>3</issue><spage>237</spage><epage>244</epage><pages>237-244</pages><issn>0033-3182</issn><eissn>1545-7206</eissn><abstract>Background The use of antidepressant drugs in fibromyalgia is extensive despite small evidence of the real impact in the clinical practice setting. This study was aimed to evaluate the long-term efficiency of antidepressant treatment in fibromyalgia and the role of psychosocial factors in treatment response. Methods A total of 102 consecutive patients with fibromyalgia from primary health care centers were studied with psychopathological and psychological assessment interviews and questionnaires. Sustained release venlafaxine was added to previous treatments in flexible doses from 150 to 300 mg daily for a 6-month period. Efficacy measures included the Clinical Global Impression (CGI) scale (patient and clinician versions) and the Fibromyalgia Impact Questionnaire (FIQ) score reduction. Results At 6 months, 48% patients were considered responders to treatment (CGI change score 1 or 2) and 23.5% had a mild response. Of note, 57.8% had less fatigue and 31.4% had less pain. The proportion of responders was greater in the group with major depression (65%) than in those without depression (45%), but the difference did not reach statistical significance. However, the reduction of FIQ scores was significantly greater in depressed (21.1; IQR: 1.4–42.0) than in non-depressed patients (41.4; IQR: 23.6–52.6) (P < 0.05). FIQ score reduction was significantly smaller in patients taking concomitant opiate treatment (P < 0.01) and in patients seeking incapacitation (P < 0.01). Conclusion Antidepressant treatment in fibromyalgia was effective in patients with and without major depression, but the functional response was greater in depressed patients. Treatment response to antidepressants might be significantly influenced by attitudinal and psychosocial factors of the disease.</abstract><cop>Arlington, VA</cop><pub>Elsevier Inc</pub><pmid>21565595</pmid><doi>10.1016/j.psym.2010.12.014</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Antidepressive Agents, Second-Generation - administration & dosage Antidepressive Agents, Second-Generation - therapeutic use Biological and medical sciences Cyclohexanols - administration & dosage Cyclohexanols - therapeutic use Delayed-Action Preparations Depressive Disorder, Major - complications Depressive Disorder, Major - drug therapy Female Humans Internal Medicine Interview, Psychological Leiomyoma - complications Leiomyoma - drug therapy Leiomyoma - psychology Male Medical sciences Neuropharmacology Pharmacology. Drug treatments Psychiatric Status Rating Scales Psychiatry Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease) Psychology. Psychoanalysis. Psychiatry Psychopharmacology Surveys and Questionnaires Treatment Outcome Venlafaxine Hydrochloride |
| title | Psychological Factors Affecting Response to Antidepressant Drugs in Fibromyalgia |
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