Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0016053 (fibromyalgia)
 4,687 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Somatization disorder (SD) is commonly seen in medical clinics and is associated with significant impairment in functioning as well as excessive utilization of health care. While antidepressants have been studied in some functional somatic syndromes such as fibromyalgia and chronic fatigue, there are no pharmacologic treatment studies of SD itself. In this prospective, 8-week, open-label study, 15 patients diagnosed with either full SD or abridged somatization, by Escobar's criteria (four unexplained physical symptoms for men or six for women), were given nefazodone, titrated to 150 mg bid. The primary outcomes included measures of physical symptom severity (visual analogue scale), functioning (SF-36), and overall improvement (CGI). Fourteen of the 15 patients achieved the target dose of 300 mg/day and completed the trial. 73% of the patients were rated as improved on the CGI, 79% improved on the self-rated visual analogue scale and 73% of the patients improved on the SF-36. There was significant improvement for the whole group (prepost) on the SF-36, as well as on the HAM-D and the HAM-A. Of the nine patients with a categorical depression diagnosis, 55% of them were rated as improved on the CGI, and 67% improved on both the VAS and the SF-36. Of the six nondepressed patients, 67% were rated as improved on the CGI, 83% improved on the SF-36, and 50% improved on the VAS. Adverse events were generally mild and resulted in only one discontinuation. Although these data need to be confirmed in a larger, double-blind, placebo-controlled trial, they suggest that patients with SD will accept and tolerate therapy with nefazodone and that nefazodone may be a useful treatment for these patients.
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PMID:Treatment of somatization disorder with nefazodone: a prospective, open-label study. 1179 53

The Fibromyalgia syndrome (FMS) is characterized by widespread pain and diffuse tenderness in specified locations. The literature clearly points out that FMS is more prevalent in females rather than males, and among patients with major depression disorder (MDD). The aim of the current study was to obtain a better conception of the linkage existing between depression, gender and FMS. Forty-two male patients and 42 age-matched females, as well as age-matched male and female healthy controls were evaluated for coexisting FMS using the American College of Rheumatology (ACR) classification criteria. Each patient completed a questionnaire characterizing the quality of their sleep, a Sheehan disability scale (SDS) and SF-36 scale to measure the quality of life. The degree of depression of each patient was scored using Hamilton depression rating scales (HDRS) and Global assessment was done using the Clinical Global Impression-Severity (CGI-S). Disease parameters were worse for men as compared to women; CGI-S: 5.4 +/- 1 (mean +/- standard deviation), versus 4.0 +/- 1 (t = 6.634, P < 0.001), HDRS: 23.9 +/- 6 versus 20.8 +/- 6 (t = 2.304, P = 0.024), respectively. Yet, FMS was more prevalent among depressed females; 26% versus 2%, (chi2(3) = 9.722, P = 0.002) and so were the average number of tender points (TP) (6.1 +/- 5 versus 2.2 +/- 3, t = 4.399, P < 0.001). The SF-36, SDS and sleep quality scores were similar between males and females. A one-way analysis of variance with gender and disease (depressed vs. non-depressed) revealed that both gender and disease were found to be significant contributing factors for the number of TP (F = 21.131, P < 0.0001; F = 65.232, P < 0.0001, respectively). A one-way analysis of covariance for TP with CGI-S and HDRS as covariates revealed that gender was a significant factor regardless of depression severity (F = 30.028, P < 0.001). CGI-S and Hamilton scores correlated with TP count in females (r = 0.396, P = 0.009, r = 0.531, P < 0.001) but not in males. Female gender is a risk factor for FMS in depressed population. Depression is associated with FMS among women but not among men. Among females, depression severity is significantly correlated to FMS severity. FMS is correlated to sleep quality and to quality of life among depressed patients.
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PMID:Fibromyalgia among major depression disorder females compared to males. 1824 52

Guidelines of the American Psychiatric Association for borderline personality disorder (BPD) indicate selective serotonin reuptake inhibitors and the serotonin and noradrenaline reuptake inhibitor (SNRI) venlafaxine for treating affective dysregulation and impulsive behavioural dyscontrol symptoms. The SNRI duloxetine has been studied in patients with major depression, generalized anxiety disorder and fibromyalgia, showing particular efficacy on somatic complaints. This study investigates duloxetine in the treatment of patients with BPD. Eighteen outpatients with a DSM-IV-TR diagnosis of BPD were treated with open-label duloxetine, 60 mg/day, for 12 weeks. Patients were assessed at baseline, week 4 and 12 with the CGI Severity item, the BPRS, the HAM-D, the HAM-A, the SOFAS, the BPD Severity Index (BPDSI) and the HSCL-90-Somatization Subscale (HSCL-90 SOM). Adverse effects were evaluated using the Dosage Record Treatment Emergent Symptom Scale. Statistics were performed with the analysis of variance. Significant P values were <or=0.05. Fourteen patients completed the study. Four patients (22.2%) discontinued treatment in the first 4 weeks because of non-compliance. A significant change was found for: BPRS, HAM-D, SOFAS, BPDSI total score and items 'impulsivity', 'outbursts of anger' and 'affective instability' and HSCL-90 SOM. Adverse effects were mild headache and nausea. Initial results suggest that duloxetine is an effective and well-tolerated treatment for BPD, with positive effects on somatic symptoms.
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PMID:Efficacy and tolerability of duloxetine in the treatment of patients with borderline personality disorder: a pilot study. 1871 47