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Au fil des ans, divers médicaments ont subi une évaluation pour une utilisation dans le traitement de la fibromyalgie. Ces médicaments comprennent des myorelaxants, des corticostéroïdes, des anti-inflammatoires non stéroïdiens (AINS), des sédatifs et des antidépresseurs tricyliques.
Les antidépresseurs tricyliques ont en fait un peu d’histoire dans le traitement de la fibromyalgie. En fait, plusieurs de ces antidépresseurs sont utilisés dans le traitement de la maladie. La nortriptyline, la doxépine et l’amitriptyline sont toutes utilisées dans le traitement de la fibromyalgie. Lorsqu’il est utilisé pour la fibromyalgie, en particulier, il a été démontré dans des études d’être l’antidépresseur le plus efficace pour traiter la maladie.
A propos de l’amitriptyline pour la fibromyalgie
L’amitriptyline est, comme mentionné, un type d’antidépresseur tricyclique (TCA) utilisé pour traiter la dépression clinique. En conséquence, il est considéré comme le TCA le plus couramment utilisé dans le monde.
L’antidépresseur a été initialement développé par Merck, et a été synthétisé en 1960. Il a ensuite été approuvé par la Food and Drug Administration en avril 1961.
Ce médicament agit comme un inhibiteur de la sérotonine et de la norépinéphrine. Le mécanisme d’action du médicament agit fortement sur le transporteur de la sérotonine, alors qu’il provoque un effet modéré sur le transporteur de norépinéphrine. Cependant, il ne fait rien pour affecter le transporteur de dopamine.
Amitriptyline est utilisé pour plusieurs conditions médicales, y compris son utilisation approuvée par la FDA pour le trouble dépressif majeur. Cela n’empêche pas d’autres ressources médicales de prétendre que cela joue un rôle dans le rétablissement d’autres conditions similaires.
On dit même que l’amitriptyline agit plus efficacement que les autres antidépresseurs lors du traitement des troubles. Fait intéressant, il est en fait passé pour d’autres antidépresseurs plus récents, car il est connu pour provoquer des effets secondaires et peut devenir très toxique s’il est consommé en surdosage.
Les antidépresseurs et la fibromyalgie
Divers médicaments sont utilisés pour traiter les symptômes de la fibromyalgie. Les médicaments les plus courants comprennent des analgésiques, des somnifères et divers antidépresseurs. On dit que les antidépresseurs aident à traiter les symptômes de la fibromyalgie provenant du dysfonctionnement des fonctions régulières du cerveau .
Les antidépresseurs, en particulier les antidépresseurs tricyliques, ont été utilisés dans le traitement de la fibromyalgie pendant des années. Les antidépresseurs tricyliques sont en fait certains des antidépresseurs les plus anciens sur le marché, et ont été utilisés dans les traitements de la fibromyalgie pendant des années.
Les antidépresseurs tricyliques comme l’amitriptyline agissent en stimulant les niveaux de produits chimiques ou de neurotransmetteurs du cerveau. Lorsque les niveaux de neurotransmetteurs sont renforcés, il empêche le cerveau de succomber à une altération de sa fonction naturelle. Ces antidépresseurs stimulent principalement les neurochimiques sérotonine et norépinéphrine. Après avoir pris ces antidépresseurs, les personnes souffrant de douleur chronique se sentent généralement beaucoup mieux, car ils sont connus pour avoir des niveaux inférieurs de ces neurotransmetteurs mentionnés ci-dessus présents dans leur cerveau.
Les antidépresseurs tricyliques jouent également un rôle dans la relaxation des muscles endoloris. Il stimule également l’analgésique naturel du corps, également connu sous le nom d’endorphines. Même si ces médicaments ont des résultats positifs pour des conditions comme la fibromyalgie, ils ont divers effets secondaires qui pourraient les rendre difficiles à prendre sur une base régulière.
Fait intéressant, les antidépresseurs tricyliques prescrits pour la fibromyalgie comprennent la duloxétine, le milnacipran et la venlafaxine. La duloxétine et le milnacipran sont déjà approuvés par la Food and Drug Administration pour le traitement de la fibromyalgie.
Venlafaxine a moins de recherche et, par conséquent, des preuves le supportant comme traitement efficace. D’autres antidépresseurs qui ont été étudiés et proposés comme traitements potentiels de la fibromyalgie comprennent le citalopram, la paroxétine et la fluoxétine.
Amitriptyline tombe dans la catégorie des antidépresseurs tricyliques non testés relatifs sans autre soutien comme un traitement de la fibromyalgie. Cependant, il n’a pas empêché les chercheurs de l’étudier et son potentiel en tant que traitement efficace pour la fibromyalgie.
Études sur l’amitriptyline
Les antidépresseurs ont été utilisés pour traiter les troubles de la douleur chronique pendant des années. Même si c’est vrai, il existe seulement un nombre limité d’études couvrant la façon dont les antidépresseurs tricyliques aident les gens à traiter leurs symptômes de la fibromyalgie.
Selon les informations recueillies sur la fibromyalgie et les antidépresseurs, les antidépresseurs comme les antidépresseurs tricycliques ont produit des améliorations légères à modérées dans les symptômes [de la fibromyalgie]. Dans des études contrôlées, on a constaté que jusqu’à un tiers à la moitié des patients suivis répondaient à un traitement médicamenteux.
Il y avait une étude qui avait testé les effets de l’amitriptyline et de la fluoxétine sur les patients atteints de fibromyalgie. Les patients de cette étude ont reçu 25 mg d’amitriptyline, tandis que d’autres ont reçu 20 mg de fluoxétine.
En conséquence, les patients ont constaté que l’un ou l’autre médicament aidait à réduire leurs symptômes de fibromyalgie. Les patients qui ont pris les deux médicaments ont trouvé que la combinaison était réellement «deux fois plus efficace» que de prendre un seul médicament.
Les doses utilisées pour l’amitriptyline pour la fibromyalgie sont beaucoup plus faibles que les doses habituelles pour le traitement de la dépression. Dans la plupart des cas, le dosage peut être commencé aussi bas que 10 mgs chaque jour, pris 2 à 3 heures avant d’aller dormir. Cela permet au patient de profiter des effets sédatifs du médicament sans éprouver ces mêmes effets lorsqu’il est éveillé.
Une autre étude de l’amitriptyline a suivi 70 patients différents atteints de fibromyalgie. Le but principal de l’étude était d’évaluer l’efficacité d’une dose régulière de 50 mg pour la fibromyalgie.
Les résultats de l’étude ont révélé des données intéressantes. Les patients qui avaient reçu la dose régulière de 50 mg de fibromyalgie ont constaté une «amélioration significative de la qualité de leur sommeil, de la raideur matinale et des seuils de douleur». Le «score du point sensible» pris à l’époque ne s’est pas amélioré.
Des études plus récentes concernant le médicament pour les patients fibromyalgiques suivent la plus récente itération des critères de la fibromyalgie. Une complication des données d’autres études sur le médicament a révélé que «l’amitriptyline pour la fibromyalgie peut continuer à être utilisé pour le traitement [de la douleur neuropathique], mais la plupart des patients n’obtiendront pas suffisamment de soulagement de la douleur.
Diverses études recueillies dans la complication ont duré jusqu’à 6 semaines (en moyenne). Ils ont également testé entre 15 et 100 participants, et quatre des études ont accueilli plus de 100 participants. Chaque étude administrait des doses comprises entre 15 mg et 125 mg.
Certaines études ont graduellement augmenté la dose à des intervalles choisis de l’étude. Dans l’ensemble, aucune preuve concrète n’a été trouvée pour soutenir l’amitriptyline comme traitement efficace pour la fibromyalgie. Certaines études ont montré qu’il peut jouer un rôle dans la réduction de certaines douleurs neuropathiques, telles que la douleur associée à la fibromyalgie.
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