Psychological Factors Affecting Response to Antidepressant Drugs in Fibromyalgia

Dı́az-Marsá, Marina; Palomares, Nerea; Morón, María-Dolores; Tajima, K; Fuentes, Manuel; López-Ibor, Juan J

doi:10.1016/j.psym.2010.12.014

Cited by 5 publications

(7 citation statements)

References 26 publications

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“…Benefits of treating depression include decrease in costs and economic burden, and improvement in social, physical and mental well‐being . A study of 102 FM patients on the effects of 6 months venlafaxine therapy, showed significantly higher decreases in FIQ scores in depressed (41.4%) compared to non‐depressed FM patients (21.2%) . Recognizing and treating depression may have indirect benefits on illness behavior, increasing patients' motivations to exercise, improving sleep and function, social interaction, all being important in achieving better FM outcomes and decreasing costs .…”

Section: Discussionmentioning

confidence: 99%

The impact of depressive and bipolar symptoms on socioeconomic status, core symptoms, function and severity of fibromyalgia

2015

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Section: Discussionmentioning

confidence: 99%

The impact of depressive and bipolar symptoms on socioeconomic status, core symptoms, function and severity of fibromyalgia

2015

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“…Based on previous studies ( 27 ), we chose the clinical global impression as a proxy for the general well-being of FM patients, and we selected a number of secondary measures likely to be sensitive to the effects of the intervention. These comprised pain catastrophizing, anxiety and depressive symptoms, quality of life, and psychological flexibility, the latter of which appears to function as a transdiagnostic mediating factor for mental health and medical conditions ( 10 , 28 ).…”

Section: Methodsmentioning

confidence: 99%

“…Based on their clinical experience, the mental illness of a patient is assessed in terms of severity as: normal, not at all ill (1); borderline, mentally ill (2); mildly ill (3); moderately ill (4); markedly ill (5); severely ill (6); or extremely ill (7). It is one of the most widely used brief assessment tools in psychiatry, and it has been used in previous studies of FM ( 27 ).…”

Section: Methodsmentioning

confidence: 99%

Efficacy of “Attachment-Based Compassion Therapy” in the Treatment of Fibromyalgia: A Randomized Controlled Trial

et al. 2018

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ObjectiveThere is a growing interest in evaluating the effectiveness of compassion interventions for treating psychological disorders. The present study evaluated the effectiveness of “attachment-based compassion therapy” (ABCT) in the treatment of fibromyalgia (FM), and the role of psychological flexibility as a mediator of improvements.MethodsA total of 42 patients with FM were randomly assigned to ABCT or relaxation (active control group). Both the intervention and control condition were combined with treatment as usual (TAU). The primary outcome was functional status (FIQ), and the secondary outcomes were clinical severity (CGI-S), pain catastrophizing (PCS), anxiety (HADS-A), depression (HADS-D), quality of life (EQ-5D), and psychological flexibility (AAQ-II). Differences between the groups were estimated using mixed-effects models, and mediation assessments were conducted using path analyses.ResultsThe ABCT group demonstrated superior outcomes compared to the relaxation group, including better FIQ values after treatment (B = −3.01; p = 0.003). Differences in FIQ were maintained at 3-month follow-up (B = −3.33; p = 0.001). The absolute risk reduction in ABCT compared to relaxation increased by 40.0%, with an NNT = 3 based on criteria of ≥50% FIQ reduction after treatment. Psychological flexibility had a significant mediating effect on improvements.ConclusionThese results suggest that ABCT combined with TAU appears to be effective in the treatment of FM symptoms.Clinical Trial Registration, identifier NCT02454244.

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“…A final open‐label study evaluated the effects of variable doses of venlafaxine for 6 months on several different pain and functional status outcomes . Primary endpoints included change in score from baseline to 6 months of the Clinical Global Impression (CGI) score, Global Assessment of Function (GAF) scale, VAS for pain and fatigue, HAM‐D, HAM‐A and FIQ.…”

Section: Resultsmentioning

confidence: 99%

“…These studies all have significant limitations as seen in the grading of the evidence, which make translating findings into clinical practice difficult. Only 2 of the studies had a sample size of greater than 20 patients, and the 4 studies without placebo control make them very susceptible to the placebo effect, further limiting their usefulness. Further, the trial that did use a placebo control used a comparatively low dose of venlafaxine, which may have contributed to the insignificant differences in the primary outcome in the intention‐to‐treat analysis .…”

Section: Resultsmentioning

confidence: 99%

A systematic review of the efficacy of venlafaxine for the treatment of fibromyalgia

2014

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Summary What is known and objective Fibromyalgia is a painful disease affecting 1–2% of the United States population. Serotonin and norepinephrine reuptake inhibitors (SNRIs), such as duloxetine and milnacipran, are well studied and frequently used for treating this disorder. However, efficacy data are limited for the SNRI venlafaxine despite its use in nearly a quarter of patients with fibromyalgia. Accordingly, we systematically reviewed the efficacy of venlafaxine for treatment of fibromyalgia. Methods PubMed, Web of Science and the Cochrane Database were searched using the terms ‘venlafaxine’ and ‘fibromyalgia’. Results were classified as primary studies or review articles based on abstract review. References of review articles were evaluated to ensure no primary studies evaluating venlafaxine were overlooked. All clinical studies that investigated venlafaxine for the treatment of fibromyalgia were included and graded on strength of evidence. Results and discussion Five studies met the inclusion criteria, including 4 open‐label cohort studies and 1 randomized, controlled trial. Study durations ranged from 6 weeks to 6 months, and study sizes ranged from 11 to 102 participants. Four of the five published studies reported improvement in at least one outcome. Generally consistent improvements were observed in pain‐related outcome measures, including the Fibromyalgia Impact Questionnaire (range, 26–29% reduction; n = 2 studies), Visual Analog Scale (range, 36–45% reduction; n = 2 studies), McGill Pain Questionnaire (48% reduction; n = 1 study) and Clinical Global Impression scale (51% had significant score change; n = 1 study). However, the few studies identified were limited by small sample size, inconsistent use of outcomes and methodological concerns. What is new and conclusion Studies assessing the efficacy of venlafaxine in the treatment of fibromyalgia to date have been limited by small sample size, inconsistent venlafaxine dosing, lack of placebo control and lack of blinding. In the context of these limitations, venlafaxine appears to be at least modestly effective in treating fibromyalgia. Larger randomized controlled trials are needed to further elucidate the full benefit of venlafaxine.

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Psychological Factors Affecting Response to Antidepressant Drugs in Fibromyalgia

Cited by 5 publications

References 26 publications

The impact of depressive and bipolar symptoms on socioeconomic status, core symptoms, function and severity of fibromyalgia

The impact of depressive and bipolar symptoms on socioeconomic status, core symptoms, function and severity of fibromyalgia

Efficacy of “Attachment-Based Compassion Therapy” in the Treatment of Fibromyalgia: A Randomized Controlled Trial

A systematic review of the efficacy of venlafaxine for the treatment of fibromyalgia

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