Trazodone for the treatment of fibromyalgia: an open-label, 12-week study

From:http://www.biomedcentral.com/1471-2474/11/204

Trazodone for the treatment of fibromyalgia: an open-label, 12-week study
Piedad Morillas-Arques, Carmen Ma Rodriguez-Lopez, Rocio Molina-Barea, Fernando Rico-Villademoros and Elena P Calandre*
* Corresponding author: Elena P Calandre calandre@gmail.com
Author Affiliations
Instituto de Neurociencias y Centro de Investigaciones Biomédicas, Universidad de Granada, Granada, Spain
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BMC Musculoskeletal Disorders 2010, 11:204 doi:10.1186/1471-2474-11-204
The electronic version of this article is the complete one and can be found online at: http://www.biomedcentral.com/1471-2474/11/204
Received:
9 May 2010
Accepted:
10 September 2010
Published:
10 September 2010
© 2010 Morillas-Arques et al; licensee BioMed Central Ltd.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background
Despite its frequent use as a hypnotic, trazodone has not been systematically assessed in fibromyalgia patients. In the present study have we evaluated the potential effectiveness and tolerability of trazodone in the treatment of fibromyalgia.
Methods
A flexible dose of trazodone (50-300 mg/day), was administered to 66 fibromyalgia patients for 12 weeks. The primary outcome measure was the Pittsburgh Sleep Quality Index (PSQI). Secondary outcome measures included the Fibromyalgia Impact Questionnaire (FIQ), the Beck Depression Inventory (BDI), the Hospital Anxiety and Depression Scale (HADS), the Brief Pain Inventory (BPI), the Short-Form Health Survey (SF-36), and the Patients' Global Improvement Scale (PGI). Trazodone's emergent adverse reactions were recorded. Data were analyzed with repeated measures one-way ANOVA and paired Student's t test.
Results
Trazodone markedly improved sleep quality, with large effect sizes in total PSQI score as well on sleep quality, sleep duration and sleep efficiency. Significant improvement, although with moderate effect sizes, were also observed in total FIQ scores, anxiety and depression scores (both HADS and BDI), and pain interference with daily activities. Unexpectedly, the most frequent and severe side effect associated with trazodone in our sample was tachycardia, which was reported by 14 (21.2%) patients.
Conclusions
In doses higher than those usually prescribed as hypnotic, the utility of trazodone in fibromyalgia management surpasses its hypnotic activity. However, the emergence of tachycardia should be closely monitored.