Pregabalin reduced pain in fibromyalgia patients with comorbid depression

SAN DIEGO — Patients with fibromyalgia and comorbid depression who were treated with pregabalin and antidepressant medication had significant improvement in pain, according to research presented at the American College of Rheumatology annual meeting.

“Patients with fibromyalgia often have comorbid depression,” Lesley M. Arnold, MD, professor of psychiatry and behavioral neuroscience, University of Cincinnati College of Medicine, told Healio.com. “What we wanted to answer was… what to do with patients who present to you on an antidepressant for their depression but continue to have pain.”

Lesley M. Arnold

Researchers conducted a randomized, double blind placebo-controlled study of pregabalin (Lyrica, Pfizer) in patients with fibromyalgia (FM) and comorbid depression who were receiving a selective serotonin reuptake inhibitor (SSRI) or serotonin-norepinephrine reuptake inhibitor (SNRI) for 2 months.

Patients were randomly assigned at least one treatment with pregabalin (PGB; n=181) or placebo (n=177) for the first 6-week treatment, then switched to the alternate therapy for 6 more weeks. Pregabalin was administered at 150 mg daily at initiation and increased to 300 mg/day to 450 mg/day based on response. There was a 2-week taper washout between treatment periods. Pain score based on the mean of the prior seven daily scores was the primary efficacy endpoint.

Patients had a mean time since depression diagnosis of 12.3 years and a mean Hospital Anxiety and Depression Scale depression score of 8 (mild depression). SSRI was taken by 52.3% of patients and SNRI by 47.7%, with a mean pain score of 6.7 at baseline.

PGB treatment was associated with a decrease in mean pain score (4.84) that was significantly lower than placebo treatment (5.45) at the end of treatment (–0.61; 95% CI, –0.92 to –0.31).

Adverse events (AEs), none considered treatment-related, were reported by 77.3% of patients receiving PGB and 59.9% by placebo patients, with dizziness (28.2%) and somnolence (19.9%) reported most frequently.

“This study shows pregabalin can help reduce the severity of pain in that population of people who are also taking antidepressants for their depression,” Arnold said.

Disclosure: See the abstract for a full list of relevant financial disclosures.

For more information:

Arnold LM. #L6: Efficacy and Safety of Pregabalin with Fibromyalgia and Co-Morbid Depression Receiving Concurrent Antidepressant Therapy: A Randomized, 2-Way Crossover, Double-Blind, Placebo-Controlled Study. Presented at: the 2013 American College of Rheumatology Annual Meeting; Oct. 26-30, San Diego.