Are selective serotonin reuptake inhibitors effective against fibromyalgia symptoms?

Abstract

Introduction: Fibromyalgia (FM) syndrome is characterized by widespread chronic pain, depressive symptoms, poor sleep quality, and its correlates. Its pharmacological treatment is usually done with antidepressants and anticonvulsants, but this first line treatment is not fully available at Brazil’s public health care system. Aim: to evaluate if the use of selective serotonin reuptake inhibitors (SSRI) is related to improved depressive symptoms and correlated symptoms. Material and methods: 85 literate-women aged 30 to 65 years old with confirmed FM diagnosis were included. They were divided in 2 groups: SSRI users (n=25) and non-SSRI (n=60) users. To evaluate the severity of depressive symptoms, the Beck Depression Inventory - II was applied. The disability due to pain and the FM impact were evaluated by the Brazilian version of Profile of Chronic Pain Screen Questionnaire and Fibromyalgia Impact Questionnaire, respectively. For total sleep time (TST) and activity/rest rhythm measurements, the subjects were asked to wear a wrist actigraph. Results: Both groups had shown moderate depressive symptoms (p=0.228). A hierarchical multiple regression analysis shows that the TST and SSRI use were negatively correlated to the severity of depressive symptoms (B=-1.513 p=0.03; B=-4.269 p=0.04) whether disability due to pain was positively correlated (B=0.595 p<0.001). Conclusion: Our findings suggest that the use of SSRI can be a protective factor to FM patients with severe depressive symptoms and it can be a treatment option in FM that is available at Brazil’s public health care system.