The comparation of the effectiveness of amitriptilin and pregabalin treatment in fibromyalgia patients

Fibromyalgia Syndrome (FMS) is a kind of rheumatismal illness whose etiology is unknown. It reveals itself with widespread musculoskeletal pains, sensitiveness in particular anatomic areas and often psycohologic troubles. Apart from these sympthoms, some others such as; insomnia, pyschological problems, tiredness accompanies with FMS. For this reason, antidepressant is often used for FMS?s classical medical treatment. Hyperalgesia, allodynia and parestesia (that are seen in neuoropathic pain too) are seen in FMS. Because of this compaints in FMS?s neuoropathic pattern, the use of pregabalin that has become a current issue recently started to gain importance.In this study it is aimed to compare effectiveness of pregabalin in fibromyalgia sympthoms that are used in generally prefered amitriptilin and neuoropathic pain.For this study 71 patients who are 18 or elder than and whose neuoropathic pains are on the foreground that was chosen conveniently to the diagnostic criterions of 1990 American Collage of Rheumatology (ARC) for FMS. They were seperated in two groups. 450mg/day dose pregabalin was started to be given to 36 patients. 25mg/day amitriptilin was started to be given to 35 patients. In the beginning and in the end of 12 weeks treatment the patients were evaluated.The patients were interrogated from the point of FMS sympthoms. Fibromyalgia Impact Questionnaire, Fatigue Severity Scale, Modifiye Impact Skala, Hospital Anxiety and Depression Scale, Nottingam Health Profile, Mini Mental Test and Leeds Assesment of Neuropathic Symptoms and Sings Scala (LANSS) were performed. The experimental measurement of the pain was evaluated using an algometric pain pressure threshold (PPT) from 18 tender points and three control points. The sum of PPTs from 18 tender points and three control points was calculated as the total myalgic score. While in all of these evaluations, there was seen important improvements from both of these groups (p<0,05). It was determined that there was no important difference in the percent changes between the groups except LANSS (p>0,05). The percent changes between the groups in pregabalin was more than amitriptilin in the LANSS (p<0,05). It was seemed that BAE of tender points and total myalgia score were significantly improvement on both groups after the treatment (p<0,05). The percent changes of this parameters were more higher in Amitriptilin Group than Pregabaline Group (p<0,05).According to the result of this study, the patients who used both amitriptilin and pregabalin were benefitted from treatment. It was seen that the effect of both these medications on the pain, tiredness, insomnia, disability, psychological distress and cognitive functions weren?t different from each other. But it was observed that amitriptilin improves the experimantal pain more than pregabalin and pregabalin improves the neuropathic pain more. According to the results FMS patients whose neuoropathic pain are on the foreground can be suggested to prefer pregabalin firstly.Key Words: Fibromyalgia Syndrome, neuoropathic pain, amitriptilin, pregabalin, pain pressure threshold