Repositório Digital

A- A A+

Melatonin analgesia is associated with improvement of the descending endogenous pain-modulating system in fibromyalgia : a phase II, randomized, double-dummy, controlled trial

.

Melatonin analgesia is associated with improvement of the descending endogenous pain-modulating system in fibromyalgia : a phase II, randomized, double-dummy, controlled trial

Mostrar registro completo

Estatísticas

Título Melatonin analgesia is associated with improvement of the descending endogenous pain-modulating system in fibromyalgia : a phase II, randomized, double-dummy, controlled trial
Autor Zanette, Simone de Azevedo
Vercelino, Rafael
Laste, Gabriela
Rozisky, Joanna Ripoll
Schwertner, André
Machado, Caroline Buzzatti
Xavier , Fernando Antonio Costa
Souza, Izabel Cristina Custodio de
Deitos, Alícia
Torres, Iraci Lucena da Silva
Caumo, Wolnei
Abstract Background: Central disinhibition is a mechanism involved in the physiopathology of fibromyalgia. Melatonin can improve sleep quality, pain and pain threshold. We hypothesized that treatment with melatonin alone or in combination with amitriptyline would be superior to amitriptyline alone in modifying the endogenous pain-modulating system (PMS) as quantified by conditional pain modulation (CPM), and this change in CPM could be associated with serum brain-derived neurotrophic factor (BDNF). We also tested whether melatonin improves the clinical symptoms of pain, pain threshold and sleep quality. Methods: Sixty-three females, aged 18 to 65, were randomized to receive bedtime amitriptyline (25 mg) (n = 21), melatonin (10 mg) (n = 21) or melatonin (10 mg) + amitriptyline (25 mg) (n = 21) for a period of six weeks. The descending PMS was assessed with the CPM-TASK. It was assessed the pain score on the Visual Analog Scale (VAS 0-100 mm), the score on Fibromyalgia Impact Questionnaire (FIQ), heat pain threshold (HPT), sleep quality and BDNF serum. Delta values (post- minus pre-treatment) were used to compare the treatment effect. The outcomes variables were collected before, one and six weeks after initiating treatment. Results: Melatonin alone or in combination with amitriptyline reduced significantly pain on the VAS compared with amitriptyline alone (P < 0.01). The delta values on the VAS scores were-12.85 (19.93),-17.37 (18.69) and-20.93 (12.23) in the amitriptyline, melatonin and melatonin+amitriptyline groups, respectively. Melatonin alone and in combination increased the inhibitory PMS as assessed by the Numerical Pain Scale [NPS(0-10)] reduction during the CPM-TASK:-2.4 (2.04) melatonin + amitriptyline,-2.65 (1.68) melatonin, and-1.04 (2.06) amitriptyline, (P < 0.05). Melatonin + amitriptyline treated displayed better results than melatonin and amitriptyline alone in terms of FIQ and PPT improvement (P < 0.05, fort both). Conclusion: Melatonin increased the inhibitory endogenous pain-modulating system as assessed by the reduction on NPS(0-10) during the CPM-TASK. Melatonin alone or associated with amitriptyline was better than amitriptyline alone in improving pain on the VAS, whereas its association with amitriptyline produced only marginal additional clinical effects on FIQ and PPT. Trial registration: Current controlled trail is registered at clinical trials.gov upon under number NCT02041455. Registered January 16, 2014.
Contido em BMC pharmacology and toxicology. London. Vol. 15 (July 2014), p. 40 [14 p.]
Assunto Amitriptilina
Dor
Ensaio clínico
Fator neurotrófico derivado do encéfalo
Fibromialgia
Melatonina
[en] Amitriptyline
[en] BDNF
[en] Clinical trial
[en] CPM
[en] Melatonin
Origem Estrangeiro
Tipo Artigo de periódico
URI http://hdl.handle.net/10183/110229
Arquivos Descrição Formato
000937728.pdf (911.1Kb) Texto completo (inglês) Adobe PDF Visualizar/abrir

Este item está licenciado na Creative Commons License

Este item aparece na(s) seguinte(s) coleção(ões)


Mostrar registro completo

Percorrer



  • O autor é titular dos direitos autorais dos documentos disponíveis neste repositório e é vedada, nos termos da lei, a comercialização de qualquer espécie sem sua autorização prévia.
    Projeto gráfico elaborado pelo Caixola - Clube de Criação Fabico/UFRGS Powered by DSpace software, Version 1.8.1.