Clinical evaluation of S-adenosyl-L-methionine versus transcutaneous electrical nerve stimulation in primary fibromyalgia

Benedetto, Paolo Di; Iona, Leo; Zidarich, V.

doi:10.1016/s0011-393x(05)80250-4

Cited by 46 publications

(25 citation statements)

References 8 publications

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“…One compared effectiveness to s-adenosyl-l-methionin (SAMe), one to warmth therapy, one to massage therapy or sham TENS, and one to placebo. When compared to SAMe, TENS was not effective; however, TENS application was being applied at minimal intensities that caused a tingling sensation over 4 tender points [11]. We, and others, have previously shown that TENS applied at inadequate intensities does not reduce pain or increase pressure pain thresholds (PPTs) [4,48,49].…”

Section: Discussionmentioning

confidence: 99%

Transcutaneous electrical nerve stimulation reduces pain, fatigue and hyperalgesia while restoring central inhibition in primary fibromyalgia

Dailey

Rakel

Vance

et al. 2013

Pain

204

221

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Because TENS works by reducing central excitability and activating central inhibition pathways, we tested the hypothesis that TENS would reduce pain and fatigue and improve function and hyperalgesia in people with fibromyalgia who have enhanced central excitability and reduced inhibition. The current study used a double-blinded randomized, placebo controlled cross-over design to test effects of a single treatment of TENS in people with fibromyalgia. Three treatments were assessed in random order: active TENS, placebo TENS, no TENS. The following measures were assessed before and after each TENS treatment: pain and fatigue at rest and movement, pressure pain thresholds (PPTs), 6 minute walk test (6MWT), range of motion (ROM), five time sit to stand test (FTSTS), and single leg stance (SLS). Conditioned pain modulation (CPM) was completed at end of testing. There was a significant decrease in pain and fatigue with movement for active TENS compared to placebo and no TENS. PPTs increased at site of TENS (spine) and outside site of TENS (leg) when compared to placebo TENS or no TENS. During Active TENS CPM was significantly stronger compared to placebo TENS and no TENS. No changes in functional tasks were observed with TENS. Thus, the current study suggests TENS has short-term efficacy in relieving symptoms of fibromyalgia while the stimulator is active. Future clinical trials should examine the effects of repeated daily delivery of TENS, similar to how TENS is used clinically, on pain, fatigue, function and quality of life in individuals with fibromyalgia.

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Section: Discussionmentioning

confidence: 99%

Transcutaneous electrical nerve stimulation reduces pain, fatigue and hyperalgesia while restoring central inhibition in primary fibromyalgia

Dailey

Rakel

Vance

et al. 2013

Pain

204

221

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“…The only study to evaluate a non-pharmacological against a pharmacological intervention found transcutaneous electrical nerve stimulation to be inferior to adenosyl-L-methionine (an antidepressant) on 3 of the 13 outcomes assessed [23]. There were no significant differences in respect of subjective pain, sleep or fatigue.…”

Section: Transcutaneous Electrical Nerve Stimulation (Tens)mentioning

confidence: 96%

Is There a Role for Cytokine Based Therapies in Fibromyalgia

Wallace¹

2006

CPD

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The etiology of fibromyalgia syndrome (FM) is uncertain and the prognosis for symptomatic recovery is generally poor. A wide variety of interventions are used in the management of FM. There is, however, no clear consensus on the treatment of choice and FM remains relatively refractory to treatment. Therefore, prevention, causal therapy and rehabilitation are not possible. FM patients frequently use alternative therapies, indicating dissatisfaction or ineffectiveness of traditional medical therapy. Alternative therapies are generally perceived to be more "natural" and as a result, to have fewer adverse effects. Despite the positive results found, the number of publications related to the application of physical therapy modalities such as acupuncture, transcutaneous electrical stimulation, laser, biofeedback, electrotherapy and magnetic field is still scant, especially concerning FM treatment. The demonstration of a long-term effective intervention for managing the symptoms associated with FM is needed. Multidisciplinary approaches to management include physical and medical therapeutic strategies. Treatment modalities should be individualised for patients based on target symptoms and impairment in functioning. Patience and positive attitude on part of the physician and active involvement of patients and their families in treatment are likely to enhance improvement. It can be concluded that there is a need for larger, more systematic and methodologically sound randomised controlled clinical trials to evaluate the effectiveness of physical therapy modalities of managing FM. We will review some of the existing studies of physical therapy relevant in the treatment of FM and give some practical advice for their use.

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“…The mechanism of action for this finding remains to be known; however, it might be due to its influence on inflammation and pain [18, 38]. Supporting this hypothesis, two separate randomized clinical trials testing SAMe for the treatment of fibromyalgia found modest improvements in fatigue in their subset analyses [39, 40]. Given the exploratory nature of this finding, SAMe should be considered for testing for cancer-related and post-menopausal fatigue.…”

Section: Discussionmentioning

confidence: 99%

Phase II evaluation of S-adenosyl-L-methionine (SAMe) for the treatment of hot flashes

Kadakia

Loprinzi

Atherton

et al. 2015

Support Care Cancer

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Purpose Hot flashes are a significant source of symptom burden that negatively impacts quality of life (QOL). For women who have contraindications to, or are unwilling to consider, estrogens or antidepressants for bothersome hot flashes, there are limited effective pharmacologic or complementary and alternative medicines. Methods This single-arm phase II trial studied the efficacy of S-adenosyl-L-methionine (SAMe) for the treatment of hot flashes. Eligible women were required to have reported ≥14 hot flashes per week for ≥1 month. The patients were treated with SAMe at a dose of 400 mg twice daily to evaluate whether a reduction in hot flash score appeared to be better than the historical placebo response of approximately 25 %. The women kept a daily hot flash diary during a baseline week and then daily during weeks 2–7. The primary endpoint was the change from baseline to week 7 in hot flash score and hot flash frequency. Secondary endpoints included toxicity analyses and the effect of SAMe on QOL. Results From October 28, 2010 to January 30, 2012, 43 women were treated with SAMe. The decrease in mean percent of baseline hot flash score and frequency was 35.4 and 32.6 %, respectively. When compared to the historical placebo response of 25 %, the effect of SAMe on hot flash score was not statistically significant (p=0.09). Treatment was well tolerated with expected grade 1/2 gastrointestinal toxicity and no negative effect on QOL. Conclusions The use of SAMe does not appear to significantly reduce hot flashes more than would be expected with a placebo.

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Clinical evaluation of S-adenosyl-L-methionine versus transcutaneous electrical nerve stimulation in primary fibromyalgia

Cited by 46 publications

References 8 publications

Transcutaneous electrical nerve stimulation reduces pain, fatigue and hyperalgesia while restoring central inhibition in primary fibromyalgia

Transcutaneous electrical nerve stimulation reduces pain, fatigue and hyperalgesia while restoring central inhibition in primary fibromyalgia

Is There a Role for Cytokine Based Therapies in Fibromyalgia

Phase II evaluation of S-adenosyl-L-methionine (SAMe) for the treatment of hot flashes

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