Comparing the efficacy and safety of duloxetine and amitriptyline in the treatment of fibromyalgia: overview of systematic reviews

Farias, Áurea Dias de; Eberle, Luciana; Amador, Tânia Alves; Pizzol, Tatiane da Silva Dal

doi:10.1186/s42358-020-00137-5

Cited by 12 publications

(6 citation statements)

References 28 publications

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“…[19][20] Another recent study confirms that both antidepressants, though to varying degrees depending on the patient's symptoms and profile, are useful in treating fibromyalgia. 21 A recent research corroborated these findings by revealing a statistically significant difference between the two groups, with 62% (n=62) of Group-A patients improving after treatment compared to 35% (n=35) of Group-B patients improving. The pain-relieving effects of duloxetine were found to be significantly greater than those of amitriptyline in individuals with diabetic neuropathy.…”

Section: Discussionmentioning

confidence: 73%

Management of Diabetic Neuropathy: A Comparison of Duloxetine with Amitriptyline

Azhar¹,

Tasleem²,

Khan³

et al. 2022

PJMHS

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Objective: To evaluate the pain-relieving effects of duloxetine vs those of amitriptyline in the treatment of diabetic neuropathy. Methodology: In this randomized trial control, 150 cases of diabetic neuropathy by using convenient sampling technique from Medical Department of Madinah Teaching Hospital, Faisalabad were enrolled and divided in 2 equal groups randomly. Group A was assigned to (Duloxetine) and B assigned to (Amitriptyline). Patients received the trial drug in the morning with water for 6 weeks. Group A got 60 mg of Duloxetine and Group B 75 mg of amitriptyline. VAS pain rating. Patient consultations included a diary card. Patients recorded daily improvements on a visual analogue scale for the first three weeks. We administered three weeks of medicine and arranged an examination in week 6. When pain levels were 50% lower than baseline, we rated them as reduced. Patients were phoned. Results: The mean age was 46.19+6.39 years. 41(54.67%) of Group-A and 39(52%) of Group-B were male, whereas 34(45.33%) and 36(48%) were female. Both groups' mean VAS pain ratings were 1.48+0.50; p = 0.746 shows no difference. Group-A (0.48+0.50) and Group-B (0.92+0.69) vary significantly (p=0.0001). Group-A (52%) and Group-B (28%) were effectively treated after 6 weeks, p=0.002. Conclusion: Our research shows that duloxetine is superior to amitriptyline for the management of diabetic neuropathy, especially in terms of minimising the frequency with which patients report experiencing pain. Keywords: Diabetic neuropathy, management, duloxetine, amitriptyline, efficacy

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Section: Discussionmentioning

confidence: 73%

Management of Diabetic Neuropathy: A Comparison of Duloxetine with Amitriptyline

Azhar¹,

Tasleem²,

Khan³

et al. 2022

PJMHS

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“…Duloxetine is a FDA approved tricyclic reuptake inhibitor, exerting its function through inhibiting the reuptake of 5-HT and NE by neurons, so as to increase their concentration in centrum and spinal cord [11]. It can be applied to acute severe depression, generalized anxiety disorder, peripheral neuropathic pain and FM [12][13][14][15][16]. Ozone is a powerful oxidant that is extremely unstable, and it can break down to monatomic oxygen and hydroxide radical with very strong oxidizing power [17].…”

Section: Resultsmentioning

confidence: 99%

Therapeutic effect of duloxetine combined with ozone trigger point injection on fibromyalgia---A retrospective observational study

Chen

Zhou

et al. 2021

Preprint

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ImportanceFibromyalgia (FM) is a common clinical chronic disease, mainly manifested as generalized chronic muscle pain and discomfort throughout the body, often accompanied by various emotional disorders such as depression, anxiety, cognitive impairment and sleep disorder, which seriously affects the quality of life of patients. However, there has not been adequately good treatment methods in clinically, so it is urgent to seek a better treatment method. In this study, duloxetine combined with ozone pain point injection was used to treat FM patients, and the clinical efficacy of the patients was observed.ObjectiveTo determine whether duloxetine combined with ozone pain point injection is safe and efficacious in the treatment of Fibromyalgia.MethodsAccording to the final treatment plan selection, the patients diagnosed with FM in the Pain Department of Shiyan Taihe Hospital, were selected from July 2017 to July 2020. After communication and written consent, 66 patients were injected with drugs and ozone pain point. Actually 60 cases finished the study procedure and follow-up. The age ranged from 22 to 57 years, and the course of the disease ranged from 2 to 8 years. In this study, a crossover design was adopted, and random number table method was used to enter the group. The patients were randomly divided into duloxetine group (group D), ozone injection group (group O) and duloxetine-ozone injection group (group D+O), with 20 patients in each group. Each group was given corresponding treatment. VAS, FIQ, PSQI and HAMD scales were used to evaluate and calculate the number of pain points, so as to observe and evaluate the clinical efficacy of patients.ResultsIn terms of pain, there was no significant difference among the groups before treatment. After 2 weeks and 4 weeks of treatment, the VAS scores in each group were significantly lower than before intervention (F=324.365 P < 0.05). The number of pain points in each group was significantly lower than before intervention, and the difference was statistically significant (F=514.046 P < 0.05). It was observed that the analgesic effect of duloxetine combined with ozone pain point injection in the treatment of fibromyalgia was better than that of single therapy. There was no significant difference in quality of life among the groups before treatment. After 2 weeks and 4 weeks of treatment, the FIQ of each group was significantly lower than that before intervention, and the difference was statistically significant (F = 324.365, P<0.05). It was observed that duloxetine combined with ozone pain point injection for fibromyalgia significantly improved the quality of life of patients, especially in terms of improving sleep, compared with treatment alone. At the end of 4 weeks of treatment, HAMD scores for depressive symptoms were significantly lower in all 3 groups than before intervention (F=1079.961, P<0.05), and loxetine combined with ozone pain point injection for fibromyalgia had a more significant antidepressant effect (F=5.089, P <0.05).ConclusionThis study confirmed that duloxetine combined with ozone pain-point injection can effectively relieve pain in patients with FM, significantly improve the accompanying symptoms of sleep disorder and depression, and improve the quality of life of patients, which is worthy of clinical promotion.

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“…The limited sample size and unstandardized antiviral therapy seemed to have had an impact on the preventive efficacy. Consequently, we speculate that pre-emptive duloxetine, which has similar mechanisms and is safer in older patients [25], provided shortly after VZV reactivation may proactively stabilize the inhibitory balance before sensitization occurs. If successful, this stabilization will help reduce the incidence of PHN.…”

Section: Background and Rationale {6a}mentioning

confidence: 99%

Effect of duloxetine premedication for postherpetic neuralgia within 72 h of herpes zoster reactivation [PROCESS]: a study protocol for a randomized controlled trial

Chen

Shrestha

Zhao

et al. 2020

Trials

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Background Postherpetic neuralgia (PHN) is the most common complication attributed to herpes zoster, which involves the reactivation of residual varicella zoster virus. It has been reported previously that pre-emptive amitriptyline following acute herpes zoster has shown latent positive effects in the prevention of PHN. In this study, by interfering with the same targets, norepinephrine and serotonin, we aim to evaluate whether pre-emptive duloxetine may proactively prevent PHN development. Methods This is a nationwide multicentric, randomized, open-label, blinded-endpoint study that will recruit 750 participants from 18 primary centres in China. Patients aged more than 50 years who are diagnosed with uncomplicated HZ, present with vesicles within 72 h of their emergence, and have an average pain score of at least 40/100 mm on a visual analogue scale (VAS, 0 mm = no pain, 100 mm = worst possible pain, at opposite ends of a 100-mm line) will be recruited for this study. Participants will be randomized into a duloxetine arm and a control arm. Participants allocated to the duloxetine arm will be given antivirals, analgesics and duloxetine, while those allocated to the control arm will receive antivirals and analgesics but no duloxetine. The primary outcome of this study is preventive efficacy against PHN, which will be evaluated based on a 100 mm VAS. Any pain scores other than 0 mm on the VAS 12 weeks after HZ onset will be defined as PHN. The secondary outcomes will consist of the average weekly VAS score, the average weekly consumption of each analgesic, weekly feature of the pain, patients’ quality of life based on the 12-item Short-Form Health Survey, Patient Global Impression of Change Scale, sleep quality as evaluated by the Pittsburgh Sleep Quality Index and adverse events during the study period. Discussion This study will investigate a prophylactic approach for reducing the prevalence of postherpetic neuralgia with duloxetine and will add significant new knowledge on the preventive effects of duloxetine on PHN. Trial registration Clinicaltrials.gov NCT04313335. Registered on 18 March 2020.

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Comparing the efficacy and safety of duloxetine and amitriptyline in the treatment of fibromyalgia: overview of systematic reviews

Cited by 12 publications

References 28 publications

Management of Diabetic Neuropathy: A Comparison of Duloxetine with Amitriptyline

Management of Diabetic Neuropathy: A Comparison of Duloxetine with Amitriptyline

Therapeutic effect of duloxetine combined with ozone trigger point injection on fibromyalgia---A retrospective observational study

Effect of duloxetine premedication for postherpetic neuralgia within 72 h of herpes zoster reactivation [PROCESS]: a study protocol for a randomized controlled trial

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