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Study Shows Combination of Drugs Effective Treatment for Fibromyalgia (FM)

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A recent scientific study has shown the medication cyclobenzaprine when combined with antidepressant medications is an effective treatment for Fibromyalgia (FM) when antidepressants alone do not lead to a reduction in FM symptoms. This was according to an abstract published in the September 2001 supplement of the Journal of Musculoskeletal Pain.

Researchers at the Private Pain Clinic and Hospital Samaritano in Sao Paulo, Brazil found that cyclobenzaprine, due to its central action for muscle relaxation, in combination with antidepressants, leads to a more restful sleep, eliminates muscle spasms, and consequently eliminates widespread pain. This combination also produced little to no side effects.

The study included 73 patients, all of who fulfilled the 1990 ACR criteria for FM. Fifty-seven women and 18 men with an age range of 18 to 83 were treated with antidepressants such as, amitriptyline, fluoxetine and venlafaxine, in standard dosages. After a period of 7 to 63 months all patients reported feeling much improved, however still complained of an unpleasant sleep, widespread pain and muscle spasms.

Cyclobenzaprine was then added to the basic medication regimen while trying to avoid side effects. All other supporting treatments such as psychological therapy, exercise, stretching, active trigger point inactivation, postural conditioning, and acupuncture were also maintained. A numerical rating scale was used to subjectively evaluate pain and quality of sleep at each patient’s return appointment.

At the first return appointment 24 patients reported a 50% increase in relief, 31 reported an improvement between 60% and 70%, 12 patients reported an improvement of 80% or more, and 6 patients reported no change. Two patients reported obstipation (severe and obstinate constipation) and one complained of dry mouth and tachycardia (relatively rapid heart action). After a follow up of 12.5 months the results of the cyclobenzaprine and antidepressant combination continued to be noticed, leading the researchers to maintain the procedure, and to begin treatment with this combination but with reduced doses of antidepressants.

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