Concomitant psychiatric disorders do not interfere with pregabalin's efficacy in decreasing fibromyalgia pain

Concomitant psychiatric disorders do not interfere with pregabalin's efficacy in decreasing fibromyalgia pain

Pregabalin (Lyrica) is associated with significant pain reduction in patients with fibromyalgia, according to data released at the 60th Annual Meeting of the American Academy of Neurology (AAN).

What's more, the pain reduction occurs even in patients with concomitant anxiety and depression.

"Concurrent psychiatric disorders are common in patients with fibromyalgia," Lesley Arnold, MD, associate professor of psychiatry at the University of Cincinnati Medical Center, said. "In fact, between one-third and two-thirds of fibromyalgia patients will develop a psychiatric disorder like anxiety or depression at some point in their lifetime."

Dr. Arnold and colleagues conducted a pooled analysis in 2,200 patients who received either 150, 300, 450 or 600 mg/d pregabalin or placebo in one of three randomized, double-blind, placebo-controlled trials.

The studies, which found that pregabalin was effective for treating fibromyalgia pain, also collected anxiety and depressive symptom levels in order to examine a possible differential pain effect of pregabalin with differing levels of baseline anxiety and depressive symptoms.

Participants satisfied American College of Rheumatology (ACR) criteria for fibromyalgia and had a pain Visual Analog Scale (VAS) score 40 mm.

In the trials, patients were followed for eight to 14 weeks.

The primary efficacy parameter was change in endpoint Mean Pain Score (MPS), where a score of zero indicated no pain and ten referred to the worst possible pain. Baseline anxiety and depressive symptom levels were assessed using the Hospital Anxiety and Depression Scales (HADS-A and HADS-D). Regression analyses assessed whether the change in pain was related to the baseline HADS-A and HADS-D levels.

Pregabalin 300, 450, and 600 mg/d, but not 150 mg/d, showed statistically significant improvements in pain compared with placebo. For each pregabalin treatment group, improvements in pain at endpoint did not show a statistically significant association with baseline levels of anxiety or depressive symptoms.

Finally, the analysis also revealed that patients' self-reported improvements were more closely associated with improvements in pain and sleep than fatigue, anxiety, or depression.


Jill Stein is a Paris-based freelance medical writer.



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