# New Antidepressant Aids Fibro Patients



## M&M (Jan 20, 2002)

This interesting information was posted to the Co-Cure mailing list:


> quote:New Antidepressant Aids Fibromyalgia SufferersBy Kathleen DohenyHealthDay ReporterTHURSDAY, Sept. 9 (HealthDayNews) -- A new antidepressantcalled duloxetine improved symptoms of fibromyalgia -- achronic and painful musculoskeletal disorder -- in women butnot in men, researchers report.Duloxetine (brand name Cymbalta) was recently approved by theU.S. Food and Drug Administration to treat major depressionand nerve pain suffered by those with diabetes. In the newstudy, published in the September issue of Arthritis &Rheumatism, the drug was used "off-label," which is legal."Antidepressants have been used to treat fibromyalgia for over10 years," said study author Dr. Lesley Arnold, an associateprofessor of psychiatry at the University of CincinnatiCollege of Medicine. "The problem has been those medicationsare poorly tolerated," she said, adding that side effectsinclude weight gain, potential heart problems and excesssedation."We have been looking for alternatives," Arnold said.Fibromyalgia is marked by body pain and muscle tenderness atseveral body sites, and there also can be headaches, sleepdisturbances and fatigue. An estimated 3 percent to 6 percentof the U.S. population has the disorder and it's far morecommon in women than in men, according to the NationalFibromyalgia Association.The cause is not known, but the disorder has been linked toabnormalities in the brain neurotransmitters serotonin andnorepinephrine. Both are linked to mood and recognized fortheir role in depression. According to the study authors,there is no FDA-approved treatment for fibromyalgia.Duloxetine works differently than some other antidepressants,affecting levels of both serotonin and norepinephrine ratherthan just serotonin, Arnold said. The drug produces thebenefits of the other antidepressants without the downsides, according to Arnold, whose colleagues on the study includedresearchers from Eli Lilly and Co., the drug's manufacturer.In the study, Arnold and her team evaluated 207 patients,mostly women, with fibromyalgia. About a third had also beendiagnosed with depression. The subjects were randomly assignedto a placebo group or to a treatment group, which received 60milligrams of duloxetine twice a day for 12 weeks.Then they were evaluated using the Fibromyalgia ImpactQuestionnaire, commonly used to determine the effect of atreatment. It asks about the ability to perform commonactivities such as going to work, shopping, doing laundry,preparing meals, driving a car and climbing stairs.Thirty percent of the women in the duloxetine group had a 50percent or greater improvement in their pain, Arnold said,compared with just 16.5 percent in the placebo group. And, shesaid, the improvement in pain reduction seemed to beindependent of the effect on mood.Those who received duloxetine demonstrated greater improvementon most of the measures evaluated on the questionnaire, shesaid.Why the treatment didn't work for the men isn't clear, Arnoldsaid, but the answer could lie with the small sample size.Only 23 men were included in the study.Dr. Daniel J. Clauw, a professor of medicine at the Universityof Michigan and an expert on fibromyalgia, called the newresearch "a well-done study."But he noted there was more improvement with daily activitiesthan pain management. He couldn't predict whether more doctorstreating patients with fibromyalgia would be likely to use thenew antidepressant off-label.But the outlook is getting brighter for those with the condition, Clauw said. "Nearly every large pharmaceuticalcompany is testing one or more compounds for fibromylagia," hesaid.More informationTo learn more about fibromyalgia, visit the NationalFibromyalgia Association at http://www.fmaware.org/fminfo/brochure.htm. (SOURCES: Lesley Arnold, M.D., associate professor,psychiatry, University of Cincinnati College of Medicine;Daniel J. Clauw, M.D., professor, medicine, University ofMichigan, Ann Arbor; September 2004 Arthritis & Rheumatism )Copyright ï¿½ 2004 ScoutNews LLC. All rights reserved.HealthDayNews articles are derived from various sources and donot reflect federal policy. healthfinderï¿½ does not endorseopinions, products, or services that may appear in newsstories. For more information on health topics in the news,visit the healthfinderï¿½ health library at http://healthfinder.gov/library/default.htm.


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## weener (Aug 15, 2000)

MrsM, this sounds promising. I'm not sure what "off label" means, do you?


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## M&M (Jan 20, 2002)

From what I understand, using a medicine "off label" means using the medicine for something other than what it is specifically marketed for.For example, I take Elavil. It is marketed as an "antidepressant", but my doctor has me take it for my insomnia. That's an "off label" usage. There are other drugs used that way as well, 1 I can think of off the top of my head is Ortho-Tricyclin. Lots of doctors prescribe that now for acne, instead of just as birth control. Also, Rogaine is a heart medication, but then they discovered that using it topically and "off label" helps stop hair loss.I could be wrong (shocking, eh?







), so don't quote me. But that's what I understand "off label" to be.


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## weener (Aug 15, 2000)

Thanks MrsM.


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## thomasw839 (Aug 21, 2002)

Thank you for posting that article, MrsM. I think this is the drug my doctor me about a year or more ago. I've been waiting for this! I will be seeing him next week and will be sure to bring along a copy of your post.


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## M&M (Jan 20, 2002)

Make sure to keep us posted Cyndie. I'll be very interested to know what your doc says. Sounds like he must keep up on the latest research. Boy, that's sure a big plus!


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