A RANDOMIZED CONTROLLED TRIAL OF CITALOPRAM IN THE TREATMENT OF FIBROMYALGIA

Amitriptyline and cyclobenzaprine have shown some efficacy in treatmen t of the generalised pain syndrome, fibromyalgia. The aim of this stud y was to examine the efficacy of antidepressant dosages of the seroton in re-uptake inhibitor citalopram in fibromyalgia. In a double-blind, placebo-controlled study 22 patients with fibromyalgia were randomized to treatment with citalopram for 4 weeks at a dosage of 20 mg a day w hile 21 received placebo. After 4 weeks the dosage was increased to 40 mg for a further 4 weeks if the subjects did not report a marked impr ovement. After the end of treatment (8 weeks) no changes were observed in self-assessment of symptoms, physician's global assessment, tender points, Beck depression score or voluntary muscle strength and no dif ferences were observed between the groups. Citalopram showed no demons trable effect on this group of pain patients. The strength of the stud y was sufficient to exclude an effect of citalopram of more than 1 ste ps of 10 on the categoric scales for pain, fatigue and general conditi on (95% confidence limit), which indicates that the sample size was su fficiently large.