Z Rheumatol 2003 Feb;62(1):42-5
[Article in German]
Stratz T, Varga B, Muller W.
Hochrhein-Institut fur Rehabilitationsforschung Rheumaklinik Bergseestr. 61 79713 Bad Sackingen, Germany.
As described elsewhere the oral administration of 5mg of the 5-HT3-receptor-antagonist Tropisetron in fibromyalgia exhibited less amelioration of pain in patients with a depression in comparison to patients without depression.
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Since an intravenous treatment seems to increase the effect of Tropisetron, the question arises whether patients with depression profit from the intravenous therapy.
Methods: 68 out patients with fibromyalgia according to ACR-criteria were enrolled in the study. The patients filled in a VAS pain and the Beck Depression Inventory (BDI) before and after a bolus i.v. injection of 5mg Tropisetron for 5 days [Beck AT, Steer Ra. Beck-Depressions-Inventar (BDI) In: Hautzinger M (Hrsg der dt. Ausg.). Testhandbuch. 1.Auflage Bern: Verlag Hans Huber, 1994]. In the beginning the patients had to have >/=40mm in the VAS pain from 0-100mm.
The patients were divided into three groups: group 1=patients with a BDI/=19 (n=22) and negative experience with antidepressive substances, and group 3=patients with a BDI>/=19 and an accompanying antidepressant drug therapy and some benefit under this therapy (n=20).
Results: Before the therapy there was no significant difference in VAS pain in the groups, but in BDI there was a significant difference between group 1 (BDI mean value 11.5) in comparison to group 2 (BDI mean value 26.1) and group 3 (BDI mean value 24.8). After therapy all three groups had a significant ameriolation of pain: group 1: p=0.000023; group 2: p=0.00073; group 3: p=0.0145. There was a significant difference between the group with BDI<19 and the group with antidepressant drug in ameriolation of pain (p=0.044).
A significant correlation was found in group 2 with Beck >/=19 between ameriolation of pain and BDI after therapy (p=0.008, r=0.666). In this group a pain-reactive depression and in group 3 an endogenous depression must be discussed.
PMID: 12624803 [PubMed – in process]