title: Tricyclic antidepressants and fibromyalgia: what is the mechanism of action?
abstract: Fibromyalgia is a chronic pain disorder of which other clinical features, such as persistent fatigue and disordered sleep, may be a secondary consequence. The initial pharmacological approach to treating the disorder is the management of the pain. Tricyclic antidepressants are the most effective drugs in use so far, especially when administered in combination with other therapies (e.g., selective serotonin re-uptake inhibitors), which suggests modulation of the neurotransmitters serotonin and noradrenaline. The effectiveness of amitriptyline and related tricyclic antidepressants, however, is consistent with the involvement of mechanisms, such as potassium channel modulation and NMDA receptor antagonism, in addition to or in place of the modulation of monoamine neurotransmitters. Investigation of the importance of each of the pharmacological properties of amitriptyline and related molecules in the management of fibromyalgia could provide clues for the rational design of new drugs.
authors.affiliation: Biomedical Research Centre and Division of Biomedical Sciences, Sheffield Hallam University, School of Science and Mathematics, City Campus, UK. K.Lawson@shu.ac.uk
authors.forename: Kim
authors.initials: K
authors.lastname: Lawson
mesh_terms: D000818:Animals; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D015306:Biogenic Monoamines / Q000037:antagonists & inhibitors; D005356:Fibromyalgia / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D010146:Pain / Q000150:complications / Q000188:drug therapy; D020919:Sleep Disorders, Intrinsic / Q000150:complications / Q000188:drug therapy
chemical_list: D000929:Antidepressive Agents, Tricyclic; D015306:Biogenic Monoamines