Amitriptyline treatment of chronic pain in patients with temporomandibulardisorders

Randomized clinical trials of amitriptyline will require data from pilot st udies to be used for sample size estimates, but such data are lacking. This study investigated the 6-week and 1-year effectiveness of low dose amitrip tyline (10-30 mg) for the treatment of patients with chronic temporomandibu lar disorder (TMD) pain. Based on clinical examination, patients were divid ed into two groups: myofascial and mixed (myofascial and temporomandibular joint disorders). Baseline pain was assessed by a Visual Analogue Scale (VA S) for pain intensity and by the McGill Pain Questionnaire (MPQ). Depressio n was assessed by the Beck Depression Inventory (BDI) short form. Patient a ssessment of global treatment effectiveness was obtained after 6 weeks and 1 year of treatment by using a five-point ordinal scale: (1) worse, (2) unc hanged, (3) minimally improved, (4) moderately improved, (5) markedly impro ved. The results showed a significant reduction for all pain scores after 6 weeks and 1 year post-treatment. The depression scores changed In depresse d but not in non-depressed patients. Global treatment effectiveness showed significant improvement 6 weeks and 1 year post-treatment. However, pain an d global treatment effectiveness were less improved at 1 year than at 6 wee ks.