Amitriptyline and cyclobenzaprine have shown some efficacy in
treatment of the generalised pain syndrome, fibromyalgia. The
aim of this study was to examine the efficacy of
antidepressant dosages of the serotonin re-uptake inhibitor
citalopram in fibromyalgia.
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In a double-blind, placebo-controlled study 22 patients with
fibromyalgia were randomized to treatment with citalopram for 4
weeks at a dosage of 20 mg a day while 21 received placebo.
After 4 weeks the dosage was increased to 40 mg for a further 4
weeks if the subjects did not report a marked improvement. After
the end of treatment (8 weeks) no changes were observed in
self-assessment of symptoms, physician's global assessment,
tender points, Beck depression score or voluntary muscle
strength and no differences were observed between the groups.
Citalopram showed no demonstrable effect on this group of pain
patients. The strength of the study was sufficient to exclude
an effect of citalopram of more than 1 steps of 10 on the
categoric scales for pain, fatigue and general condition (95%
confidence limit), which indicates that the sample size was
Norregaard J, Volkmann H, Danneskiold-Samsoe B