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New Insights into the Pathophysiology and Treatment of Fibromyalgia
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Biomedicines 2017, 5(2), 24; doi:10.3390/biomedicines5020024

A Brief Review of the Pharmacology of Amitriptyline and Clinical Outcomes in Treating Fibromyalgia

Department of Biosciences and Chemistry, Biomolecular Sciences Research Centre, Sheffield Hallam University, Sheffield S1 1WB, UK
Academic Editor: Shaker A. Mousa
Received: 12 March 2017 / Revised: 10 May 2017 / Accepted: 13 May 2017 / Published: 17 May 2017
(This article belongs to the Special Issue Drug Therapies for the Treatment of Fibromyalgia)
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Abstract

Fibromyalgia is a complex chronic condition characterized by pain, physical fatigue, sleep disorder and cognitive impairment. Evidence-based guidelines recommend antidepressants as treatments of fibromyalgia where tricyclics are often considered to have the greatest efficacy, with amitriptyline often being a first-line treatment. Amitriptyline evokes a preferential reduction in pain and fatigue of fibromyalgia, and in the Fibromyalgia Impact Questionnaire (FIQ) score, which is a quality of life assessment. The multimodal profile of the mechanisms of action of amitriptyline include monoamine reuptake inhibition, receptor modulation and ion channel modulation. Several of the actions of amitriptyline on multiple nociceptive and sensory processes at central and peripheral locations have the potential to act cumulatively to suppress the characteristic symptoms of fibromyalgia. Greater understanding of the role of these mechanisms of action of amitriptyline could provide further clues to the pathophysiology of fibromyalgia and to a preferable pharmacological profile for future drug development. View Full-Text
Keywords: fibromyalgia; amitriptyline; monoamine transporters; pain; fatigue; Fibromyalgia Impact Questionnaire fibromyalgia; amitriptyline; monoamine transporters; pain; fatigue; Fibromyalgia Impact Questionnaire
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Lawson, K. A Brief Review of the Pharmacology of Amitriptyline and Clinical Outcomes in Treating Fibromyalgia. Biomedicines 2017, 5, 24.

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