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Con los años, varios medicamentos han sido evaluados para su uso en el tratamiento de la fibromialgia. Esos medicamentos incluyen relajantes musculares, corticosteroides, medicamentos antiinflamatorios no esteroideos (AINE), sedantes y antidepresivos tricíclicos.
Los antidepresivos tricíclicos en realidad tienen algo de historia en el tratamiento de la fibromialgia. De hecho, varios de estos antidepresivos se usan en el tratamiento de la afección. La nortriptilina, la doxepina y la amitriptilina se usan en el tratamiento de la fibromialgia. Cuando se usa para la fibromialgia, en particular, se ha demostrado en estudios que es el antidepresivo más eficiente para tratar la afección.
Acerca de la amitriptilina para la fibromialgia
La amitriptilina es, como se mencionó, un tipo de antidepresivo tricíclico (TCA) utilizado para tratar la depresión clínica. Como resultado, se considera el TCA más común utilizado en todo el mundo.
El antidepresivo fue desarrollado originalmente por Merck, y se sintetizó por primera vez en 1960. Más tarde fue aprobado por la Administración de Alimentos y Medicamentos en abril de 1961.
Este medicamento funciona como un inhibidor de las sustancias químicas cerebrales serotonina y norepinefrina. El mecanismo de acción de la medicación actúa fuertemente sobre el transportador de serotonina, mientras que causa un efecto moderado sobre el transportador de norepinefrina. Sin embargo, no afecta el transportador de dopamina.
La amitriptilina se usa para varias afecciones médicas, incluido su uso aprobado por la FDA para el trastorno depresivo mayor. Eso no impide que otros recursos médicos afirmen que juega un papel en ayudar a la recuperación de otras condiciones similares.
Incluso se dice que la amitriptilina actúa de manera más eficiente que otros antidepresivos cuando se tratan trastornos. Curiosamente, en realidad se pasa por alto para otros antidepresivos más nuevos, ya que se sabe que causa efectos secundarios y puede volverse muy tóxico si se consume con una sobredosis.
Antidepresivos y fibromialgia
Varios medicamentos se utilizan para tratar los síntomas de la fibromialgia. Los medicamentos más comunes incluyen analgésicos, pastillas para dormir y diversos antidepresivos. Se dice que los antidepresivos ayudan a tratar los síntomas de la fibromialgia que se originan en la disfunción de las funciones regulares del cerebro .
Los antidepresivos, especialmente los antidepresivos tricíclicos, se han usado en el tratamiento de la fibromialgia durante años. Los antidepresivos tricíclicos son en realidad algunos de los antidepresivos más antiguos del mercado y se han utilizado en tratamientos de fibromialgia durante años.
Los antidepresivos tricíclicos como la amitriptilina funcionan al aumentar los niveles de los químicos o neurotransmisores del cerebro. Cuando se aumentan los niveles de neurotransmisores, se evita que el cerebro sucumba al deterioro en su función natural. Estos antidepresivos estimulan principalmente los neuroquímicos serotonina y norepinefrina. Después de tomar estos antidepresivos, las personas con dolor crónico generalmente se sienten mucho mejor, ya que se sabe que tienen niveles más bajos de esos neurotransmisores antes mencionados presentes en su cerebro.
Los antidepresivos tricíclicos también juegan un papel en ayudar a relajar los músculos cargados de dolor. También aumenta el analgésico natural del cuerpo, también conocido como endorfinas. A pesar de que estos medicamentos tienen resultados positivos para enfermedades como la fibromialgia, tienen varios efectos secundarios que pueden dificultar la toma de forma regular.
Curiosamente, los antidepresivos tricíclicos que se prescriben para la fibromialgia incluyen duloxetina, milnacipran y venlafaxina. Tanto la duloxetina como el milnacipran ya están aprobados por la Administración de Alimentos y Medicamentos para el tratamiento de la fibromialgia.
La venlafaxina tiene menos investigación y, por lo tanto, evidencia que la respalde como un tratamiento efectivo. Otros antidepresivos que se han estudiado y propuesto como tratamientos potenciales para la fibromialgia incluyen citalopram, paroxetina y fluoxetina.
La amitriptilina entra en la categoría de antidepresivos tricíclicos no probados sin más apoyo como tratamiento de fibromialgia. Sin embargo, no ha impedido que los investigadores lo estudien y su potencial como un tratamiento efectivo para la fibromialgia.
Estudios sobre amitriptilina
Los antidepresivos se han usado para tratar trastornos de dolor crónico durante años. Aunque eso es cierto, solo existe una cantidad limitada de estudios que cubren cómo los antidepresivos tricíclicos ayudan a las personas a tratar sus síntomas de fibromialgia.
Según la información recopilada sobre la fibromialgia y los antidepresivos, los antidepresivos como los antidepresivos tricíclicos producen mejorías de leves a moderadas en los síntomas de [fibromialgia]. En estudios controlados, se encontró que tanto como un tercio a la mitad de los pacientes monitoreados respondieron al tratamiento basado en medicamentos.
Hubo un estudio que había probado los efectos de la amitriptilina y la fluoxetina en pacientes con fibromialgia. Los pacientes en ese estudio recibieron 25 mg de amitriptilina, mientras que a otros se les administró 20 mg de fluoxetina.
Como resultado, los pacientes encontraron que cualquiera de los medicamentos ayudaron a reducir sus síntomas de fibromialgia. Los pacientes que tomaron ambos medicamentos descubrieron que la combinación en realidad era “dos veces más efectiva” que solo tomar un medicamento solo.
Las dosis utilizadas para la amitriptilina para la fibromialgia son mucho más bajas que las dosis habituales para tratar la depresión. En la mayoría de los casos, la dosificación puede comenzarse con tan solo 10 mg por día, tomados de 2 a 3 horas antes de irse a dormir. Esto le permite al paciente aprovechar los efectos sedantes de la medicación sin experimentar esos mismos efectos cuando está despierto.
Otro estudio de amitriptilina siguió a 70 pacientes diferentes con la afección con fibromialgia. El propósito principal del estudio evaluó la efectividad de una dosis regular de 50 mg para la fibromialgia.
Los resultados del estudio revelaron algunos datos interesantes. Los pacientes que habían recibido la dosis habitual de 50 mg para la fibromialgia vieron una “mejora significativa en la calidad del sueño, la rigidez matutina y los umbrales del dolor”. El “puntaje de puntos sensibles” tomado en ese momento no mejoró.
Los estudios más recientes sobre el fármaco para pacientes con fibromialgia siguen la iteración más reciente de los criterios de fibromialgia. Una complicación de los datos de otros estudios sobre el medicamento descubrió que “la amitriptilina para la fibromialgia puede continuar usándose para el tratamiento del dolor [neuropático], pero la mayoría de los pacientes no logrará suficiente alivio del dolor”.
Diversos estudios recopilados en la complicación duraron hasta 6 semanas (en promedio). También evaluaron entre 15 y hasta 100 participantes, y cuatro de los estudios albergaron a más de 100 participantes. Cada estudio administró dosis entre 15 mg y 125 mg.
Algunos estudios aumentaron gradualmente la dosis durante los intervalos seleccionados de la prueba de estudio. En general, no se encontraron pruebas concretas para apoyar la amitriptilina como un tratamiento efectivo para la fibromialgia. Algunos estudios encontraron que puede jugar un papel en la reducción de algunos dolores neuropáticos, como el dolor asociado con la fibromialgia.
Para aquellos que no entienden la fibromialgia
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