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History of depressive and/or anxiety disorders as a predictor of treatment response: A post-hoc analysis of a 12-week, randomized, double-blind, placebo-controlled trial of paroxetine controlled release in patients with fibromyalgia – Source: Progress in Neuro-psychopharmacology & Biological Psychiatry, May 8, 2009

  [ 30 votes ]   [ 1 Comment ]
By CU Pae, AA Patkar, et al. • www.ProHealth.com • May 13, 2009


[Note: paroxetine is a selective serotonin reuptake inhibitor (SSRI) antidepressant. A previous trial by Patkar, et al. reported that most Fibromyalgia patients in a group with no current depressive or anxiety disorders who took time release paroxetine (trade name Paxil) achieved improvements in overall FM impact of 25% or more.]

Background: Despite a high comorbidity of depressive and/or anxiety disorders with fibromyalgia, information on the clinical implications of this comorbidity is limited; but antidepressants are commonly prescribed to treat fibromyalgia in clinical practice. We investigated whether a history of depressive and/or anxiety disorders was associated with response to paroxetine controlled release (CR) in the treatment of fibromyalgia.

Methods: One hundred sixteen (116) fibromyalgia subjects were randomized to receive paroxetine CR or placebo for 12 weeks. The primary outcome was treatment response defined as a 25% or greater reduction in the Fibromyalgia Impact Questionnaire (FIQ) score. In multivariate logistic regression, we determined if a history of depression and/or anxiety disorders was an independent predictor of response to paroxetine CR.

Results: In logistic regression:

• The history of depression and/or anxiety did not predict treatment response as measured by a 25% or greater reduction in Fibromyalgia Impact Questionnaire (FIQ) score (OR=0.66, 95% CI=.29-1.49, Wald=0.97, p=0.32),

• While the drug status (paroxetine CR) was significantly associated with treatment response (OR=2.57, CI=1.2-5.61, Wald=5.5, p=0.02).

Conclusion: A significant proportion of patients with fibromyalgia had a history of anxiety and or depressive disorders. However response to treatment of fibromyalgia symptoms with paroxetine CR was not associated with a history of depressive and/or anxiety disorders. Our findings need to be confirmed in more adequately-powered and well-designed subsequent studies.

Source: Progress in Neuro-psychopharmacology & Biological Psychiatry, May 8, 2009. PMID: 19433129, by Pae CU, Masand PS, Marks DM, Krulewicz S, Peindl K, Mannelli P, Patkar AA. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina; Department of Psychiatry, The Catholic University of Korea College of Medicine, Seoul, South Korea. [E-mail: Ashwin Patkar, Duke University, ashwin.patkar@duke.edu]





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Article Comments Post a Comment

Fibro Fog makes these excerpts virtually impossible to understand
Posted by: RatsWife
May 20, 2009
It has to be my horrendously socked-in Fibro Fog, for I cannot comprehend what this study excerpt is relaying. Is it saying that yes, pre-existing depression/anxiety means taking this drug improves FM or not? Thereby meaning that those who were diagnosed with depression/anxiety before onset of FM had a greater chance of developing FM? I hate not being able to decipher when once I could so easily.
Reply Reply
 
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