title: The Use of Antidepressants in the Long-Term Treatment Should not Improve the Impact of Fibromyalgia on Quality of Life.
abstract: BACKGROUND
  Antidepressant (AD) drugs are effective in the short term treatment of fibromyalgia (FM). It may be useful to study the long-term impact of AD on patients with FM.
  
  
  METHODS
  One-year follow-up study on 23 females with FM divided into groups on AD (ADg-N=7), and not taking AD (NADg-N=11). Evaluation at t1 and at the end (t2) with the Fibromyalgia Impact Questionnaire (FIQ); at t2 with: SCID-IV; Mood Disorder Questionnaire (MDQ); Short Form-12; Hamilton Depression Rating Scale (HAM-D); Functioning Assessment Short Test (FAST).
  
  
  RESULTS
  After a year the AD group showed a worst impact of the disease by FIQ (p=0.017), worsened quality of life by SF-12 (p<0.01), and disability linked to bipolar symptoms by FAST (p=0.05). About 40% of the sample was screened positive at MDQ without difference in the two groups. The patients who recovered from a depressive episode did not differ between ADg and NADg (20% vs 33.3%), and were fewer than expected from the literature (40-60%). The HAM-D score at the end of the trial was worse in the ADg (p<0.03).
  
  
  CONCLUSIONS
  Observational research on few patients, not specifically designed to test the hypothesis. The results have a heuristic value only.
  
  
  CONCLUSIONS
  The results should be read in the light of the high prevalence of patients screened positive for Bipolar Disorders and of the well-known poor response of the mood symptoms to antidepressants in Bipolar Depression. The deterioration in the long-term management of FM patients following AD treatments suggests the need for new and robust studies.
authors.affiliation: Dipartimento di Sanità Pubblica e Medicina Clinica e Sperimentale, Università di Cagliari e Center of Liaison Psychiatry and Psychosomatics, University Hospital of Cagliari, Italy.
authors.forename: Mg
authors.initials: M
authors.lastname: Carta
authors.forename: V
authors.initials: V
authors.lastname: Ruggiero
authors.forename: F
authors.initials: F
authors.lastname: Sancassiani
authors.forename: F
authors.initials: F
authors.lastname: Cutrano
authors.forename: Ar
authors.initials: A
authors.lastname: Manca
authors.forename: M
authors.initials: M
authors.lastname: Peri
authors.forename: A
authors.initials: A
authors.lastname: Fais
authors.forename: E
authors.initials: E
authors.lastname: Cacace
keywords: Antidepressants; Efficacy; Fibromyalgia; Long-Term Treatment; Quality of life.