Turkish Journal of Physical Medicine and Rehabilitation 1999 , Vol 2 , Num 4

Fibromyaljinin Tedavisinde Amitriptilin ve Ketoprofen Birlikte Kullanımının Etkinliği

Nurdan Şenerdem 1 ,Afitap İçağasıoğlu 2 ,Hülya Akay 3 ,Betül Toygar 3 ,Neşe Erdoğan 1
1 SSK Göztepe Eğitim ve Araştırma Hastanesi, Fizik Tedavi ve Rehabilitasyon Kliniği, İstanbul
2 Clinic of Physical Therapy and Rehabilitation, Göztepe Training and Research Hospital, İstanbul, Turkey
3 SSK Göztepe Eğitim Hastanesi, Fizik Tedavi ve Rehabilitasyon Kliniği, İstanbul

Amitriptilin and kestorpofen in fibromyalgia- Fibromyalgia, with an unknown etiology is a disease of widespread pain, multipletender points fatigue, psychological abronmalities accompanied by poorsleep. There is no accepted therapy for fibromyalgia. Many nonsteroidal antiinflammatory drugs and tricyclic antideppressant agent have been used. The aim of this study was to evaluate the efficacy of amytriptiline alone and in combination with ketoprofen on the symptoms of fibromyalgia and to see whether the combination of a nonsteroidal agent brought any beneficial effect. According to American colloge of Rheumatology Criteria 97 patients diagnosed as fibromyalgia, with a minimum of 3 months of complaning period were randomly divided into two groups. The patients either received amytriptiline+placebo or amytriptiline+ketoprofen in a double blind formate. They were examined by thesame observer at the beginning of the study at the end of 4 and 8 weeks. The number of tendr points were recorded. Pain, morning siffness, fatigiu, sleep distrubance, patient global assessments were measured with VAS. Psychological evaluation was performed with SymptomCheckList 90. a women/man ratio was increased in favor of women. In both of the groups there was a slow but significant decrease in pain and fatigue ased in favor of women. (p= 0.000) and an improvement in atient global assesment (p= 0.000). The benefical effect seenat the end of the 4th week continued until the end of 8th week. There was no difference between the groups. There was no improvement in tender point count, sleep disturbance and morning stiffness. The psychologicalscores, remained the same at the end of thestudy.The beneficial effect seen in both of the groups were accepted as the effect of amytriptiline; combination of ketoprofen didn't bring any additive favourable effect.

Keywords : Fibromyalgia, ketoprofen, amytriptiline.