|
Research on Fibromyalgia
Fibromyalgia and migraine, two faces of the same mechanism.
Serotonin as the common clue for pathogenesis and therapy.
| AUTHORS:
| Nicolodi M; Sicuteri F
| AUTHOR AFFILIATION:
| Interuniversity Centre of
Neurochemistry, University Unit, Florence, Italy.
| SOURCE:
| Adv Exp Med Biol 1996;398:373-9
| CITATION IDS:
| PMID: 8906292 UI: 97062553
| ABSTRACT:
| In this study fibromyalgia
sufferers were randomly administered a combination of monoamine-oxidase
inhibitors (MAOIs)-A/B with 5-HTP, 5- HTP alone, MAOIs-A/B alone, or the
tricyclic drug amitriptyline in order to compare the efficacy of these
treatments. The benefits on the painful syndrome were assessed by using
Visual Analogic Scale score rating from 0 to 4. The combination of MAOIs
with 5-HTP significantly improved fibromyalgia syndrome as determined by
Visual Analogic Scale whereas the other treatments yielded poorer
benefits. No subject withdrew from the trial due to adverse effects, even
if some sleep disturbances and mild stomach-ache were reported. The
tolerability of the association MAOIs/5-HTP was good, although a transient
cheese effect occurred in one of the patients treated with MAOIs as well
as in a patient treated with the association MAOIs and 5-HTP. No one of
these two cases was due to pharmacological dietetic mistake of the
patient. In both the cases the transient hypertension was associated to
very dramatic emotional events. The benefits obtained by using the
combination of MAOIs with 5-HTP can be explained with a treatment- induced
enhancement of aminergic and serotonergic transmission. The recently shown
high prevalence of migraine in the population of fibromyalgia sufferers,
suggests a common ground shared by fibromyalgia and migraine. Migraine has
been demonstrated to be characterized by a defect in the serotonergic and
adrenergic systems. A parallel dramatic failure of serotonergic systems
and a defect of adrenergic transmission have been evidenced to affect
fibromyalgia sufferers too. Enhancing serotonergic analgesia while
increasing adrenergically mediated analgesia seems to be an important tool
in fibromyalgia. Treatment consisting with the association MAOIs/5-HTP is
aimed at enhancing serotonergic/adrenergic transmission by inducing an
up-regulation of serotonergic/adrenergic receptors and a simultaneous
increase of serotonin levels in the central nervous system.
|
| | | |
|
