title: Clinical usefulness of amitriptyline in fibromyalgia: the results of 23 N-of-1 randomized controlled trials.
abstract: Twenty-three double blind, randomized, multiple crossover trials (N-of-1 RCT) of amitriptyline were conducted in patients with fibromyalgia. The benefit of amitriptyline was assessed using a symptom questionnaire and count of tender points. To assess the usefulness of the method, the proportion of trials that provided a definite answer was examined. Completing the trial resulted in reaching a high degree of confidence in the final management decision in 74% of trials. In 35% of trials, results led to discontinuation of the drug which otherwise would have been continued indefinitely. The drug benefit, if present, was evident within first 2 weeks of therapy. We concluded that these results support the feasibility and usefulness of N-of-1 RCT in rheumatology practice.
authors.affiliation: Department of Medicine, St. Joseph's Hospital, Hamilton, ON, Canada.
authors.forename: R
authors.initials: R
authors.lastname: Jaeschke
authors.forename: J
authors.initials: J
authors.lastname: Adachi
authors.forename: G
authors.initials: G
authors.lastname: Guyatt
authors.forename: J
authors.initials: J
authors.lastname: Keller
authors.forename: B
authors.initials: B
authors.lastname: Wong
mesh_terms: D000328:Adult; D000368:Aged; D000639:Amitriptyline / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D005356:Fibromyalgia / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D011795:Surveys and Questionnaires
chemical_list: D000639:Amitriptyline