Could Antidepressants Make Fibromyalgia Worse?
We know some antidepressants have been studied for fibromyalgia and found to be beneficial. In fact, two of the three medications approved by the FDA for the treatment of fibromyalgia are SNRI (serotonin and norepinephrine reuptake inhibitor) antidepressants. However since the clinical trials required for FDA approval generally only last for a few weeks or months, little is known about the effect taking antidepressants for a long period of time has on people with FM - at least until now.
A group of Italian researchers thought it would be useful to study the long-term impact of antidepressants on FM patients.
Study Design and Results
This was a one-year follow-up study that began with 23 females with FM, who were divided into two groups: 12 were taking an antidepressant and 11 were not. Five of those taking an antidepressant dropped out of the study prior to completion. Of the seven who completed the study, five were taking an SNRI and two were taking an SSRI.
Study participants were tested at the beginning of the study and again one year later using a variety of testing instruments, such as the Fibromyalgia Impact Questionnaire, the Short Form Health Survey and the Hamilton Rating Scale for Depression. After a year, the researchers found that:
The impact of FM on patients was worse for those who were taking antidepressants.
Quality of life was worse for those taking antidepressants.
Depression scores were worse in patients taking antidepressants.
It is important to note that this was a very small observational study and additional larger studies need to be done before reaching any conclusions as to whether or not FM patients should take antidepressants for a long period of time. These findings do concern me, though, since two of the three medications most commonly prescribed for fibromyalgia are antidepressants.
It's unlikely the pharmaceutical companies who manufacture the antidepressants will take on this type of study since it could negatively impact their profits. But I hope some independent researchers will step up and take a closer look at the long-term effect antidepressants have on FM.
Source: "The Use of Antidepressants in the Long-Term Treatment Should not Improve the Impact of Fibromyalgia on Quality of Life." Clinical Practice & Epidemiology in Mental Health. 2013; 9: 120-124.