Effectiveness of cognitive-behavioral therapy and amitriptyline in patients with chronic temporomandibular disorders: a pilot study.
The aim of this pilot study was to evaluate the effectiveness of cognitive-behavioral therapy (CBT) and use of amitriptyline, a tricyclic antidepressant, in patients with chronic temporomandibular disorders (TMD). Forty-seven women (mean age = 35.4 years old) with chronic TMD were enrolled in the study and divided into 4 groups: amitriptyline; amitriptyline and CBT; placebo and CBT; and placebo only (control). Patients were managed for 7 consecutive weeks. Follow-up evaluations were done at the 1st, 7th and 11th weeks of treatment. The presence and severity of pain, levels of depression, and quality of life and sleep were measured. Data were analyzed using ANOVA, Chi-square and Cochran tests, considering a significance level of 5%. Improvements were found for all factors considered in the intragroup analysis, although no significant differences were detected among groups. However, at the end of the treatment (11 weeks of follow-up), these positive outcomes persisted only for the women treated with amitriptyline and CBT. The obtained results suggest that the combination of amitriptyline and CBT may be effective in reducing pain and depression levels as well as in improving the quality of life and sleep in patients with chronic TMD.
Department of Dentistry, UFRN - Federal University of Rio Grande do Norte, Natal, RN, Brazil. patriciascalderon@yahoo.com.br
Patrícia Dos Santos
Pdos S
Calderon
Maria de Lourdes Merighi
Mde L
Tabaquim
Luiz Carlos de
LC
Oliveira
Ana Paula Afonso
AP
Camargo
Tatiana de Cássia
Tde C
Ramos Netto
Paulo César Rodrigues
PC
Conti
D000293:Adolescent; D000328:Adult; D000639:Amitriptyline / Q000627:therapeutic use*; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D059350:Chronic Pain / Q000145:classification / Q000188:drug therapy / Q000628:therapy; D015928:Cognitive Behavioral Therapy; D003863:Depression / Q000145:classification / Q000188:drug therapy / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010147:Pain Measurement; D010865:Pilot Projects; D010919:Placebos; D011788:Quality of Life; D012890:Sleep / Q000187:drug effects / Q000502:physiology; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy / Q000628:therapy; D013705:Temporomandibular Joint Disorders / Q000145:classification / Q000188:drug therapy / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
D000929:Antidepressive Agents, Tricyclic; D010919:Placebos; D000639:Amitriptyline