title: A randomised controlled trial comparing duloxetine and acetyl L-carnitine in fibromyalgic patients: preliminary data.
abstract: OBJECTIVE
  Fibromyalgia syndrome (FMS) is a chronic disorder characterised by widespread musculoskeletal pain, troubled sleep, disturbed mood, and fatigue. Recently published reviews have demonstrated that it is influenced by various psychological aspects, and antidepressants are now considered the treatment of choice for most patients. The aim of this randomised controlled trial was to compare the effects of duloxetine and acetyl L-carnitine on pain, depression, anxiety and well-being in FMS patients.
  
  
  METHODS
  Sixty-five female outpatients with FMS diagnosed by a rheumatologist were recruited between January 2011 and May 2012, and randomised to receive duloxetine 60 mg/day or acetyl L-carnitine 1500 mg/day (500 mg t.i.d.). Drug efficacy and side effects were assessed by the same psychiatrist at baseline, and four and 12 weeks later.
  
  
  RESULTS
  Both drugs led to a general clinical improvement, with positive effects on pain and depressive symptoms; but neither induced a significant improvement in anxiety. Both drugs had a positive effect on the physical component of the quality of life, but only duloxetine improved the psychological component.
  
  
  CONCLUSIONS
  Although they need to be confirmed by further studies, these preliminary findings confirm the efficacy of duloxetine, and suggest that acetyl L-carnitine is also efficacious in improving depressive symptoms, pain, and the quality of life of FMS patients.
authors.affiliation: Rita Levi Montalcini Department of Neuroscience, University of Turin, Turin, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Leombruni
authors.affiliation: Rita Levi Montalcini Department of Neuroscience, University of Turin, Turin, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Miniotti
authors.affiliation: Rita Levi Montalcini Department of Neuroscience, University of Turin, Turin, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Colonna
authors.affiliation: Rita Levi Montalcini Department of Neuroscience, University of Turin, Turin, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Sica
authors.affiliation: Department of Psychology, University of Turin, Turin, Italy.
authors.forename: Lorys
authors.initials: L
authors.lastname: Castelli
authors.affiliation: Rheumatology Department, Azienda Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Bruzzone
authors.affiliation: Rheumatology Department, Azienda Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Parisi
authors.affiliation: Rheumatology Department, Azienda Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Fusaro
authors.affiliation: Rheumatology Unit, L. Sacco University Hospital, Milan, Italy.
authors.forename: Piercarlo
authors.initials: P
authors.lastname: Sarzi-Puttini
authors.affiliation: IRCCS Galeazzi Orthopaedic Institute, Milan, Italy.
authors.forename: Fabiola
authors.initials: F
authors.lastname: Atzeni
authors.affiliation: Rita Levi Montalcini Department of Neuroscience, University of Turin, Turin, Italy.
authors.forename: Riccardo G
authors.initials: RG
authors.lastname: Torta
mesh_terms: D000108:Acetylcarnitine / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003863:Depression / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D000068736:Duloxetine Hydrochloride; D005260:Female; D005356:Fibromyalgia / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D007558:Italy; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D010147:Pain Measurement; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D013876:Thiophenes / Q000009:adverse effects / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000700:Analgesics; D000928:Antidepressive Agents; D013876:Thiophenes; D000108:Acetylcarnitine; D000068736:Duloxetine Hydrochloride