Abstract: [The influence of depression on the effect of Tropisetron in the therapy of fibromyalgia]

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.

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]

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