FİBROMİYALJİLİ HASTALARDA KİŞİLİK ÖZELLİKLERİNE GÖRE PREGABALİN VE DULOKSETİN TEDAVİLERİNİN ETKİNLİĞİNİN KARŞILAŞTIRILMASI

Çalışmamızda fibromiyalji sendromlu (FMS) hastaları kişilik özelliklerine göre ayırıp,kişiliklerde duloksetin, pregabalin tedavisinin etkinliklerini araştırmak, etkinlikleri birbirleriylekarşılaştırmak amaçlandı. FMS’li 102 kadın hasta Eysenck Kişilik Anketi kullanılarak kişiliközelliklerine göre gruplandırıldı. Her kişilik grubu kendi arasında rastgele iki gruba ayrıldı. 12hafta süreyle gruplardan birine 60 mg/gün duloksetin, diğerine 300 mg/gün pregabalin tedavisiuygulandı. Hastaların tedavi öncesi ve sonrası ağrı şiddetleri Visual Analog Skala, uyku kaliteleriVAS-uyku skoru, depresyonları Beck Depresyon Ölçeği (BDÖ), yaşam kalitesi SF-36,fonksiyonel durumları Fibromiyalji Etki Anketi (FIQ) ile değerlendirildi. Tedaviye alınan hastaların 61’i (%59,8) nörotik, 41’i (% 40,2) dışa dönük kişilik özelliğindeydi.Nörotik grubun 30’u duloksetin, 31’i pregabalin; dışa dönüklerin 20’si duloksetin, 21’ipregabalin tedavisine alındı. Her iki ilaç SF-36’nın enerji, fiziksel rol güçlüğü, genel sağlık,ağrı, mental sağlık boyutlarında kişilik özelliklerinden bağımsız düzelme sağladı. Fizikselfonksiyonda duloksetin alan nörotik ve pregabalin alan dışa dönük grupta düzelme oldu.Emosyonel rol güçlüğünde nörotiklerde ilaçlardan bağımsız düzelme saptandı. Sosyalfonksiyonlarda hiçbir grupta iyileşme olmadı. FIQ skorunda düzelme ilaçlardan bağımsız dışadönük grupta daha fazla görüldü. BDÖ’ de düzelme duloksetin alan nörotikler ve pregabalinalan dışa dönüklerde oldu. Hassas noktalar ve VAS’da bütün gruplarda düzelme oldu. Ancakduloksetin alan nörotiklerde ve pregabalin alan dışa dönüklerde düzelme daha fazla oldu. VASuyku skorları tüm gruplarda düzelme gösterdi. FMS tedavisinde kişilik özellikleri önemlidir.Dışa dönükler tedaviye daha iyi cevap vermektedirler. Tedaviye öncelikle dışa dönüklerdepregabalin, nörotiklerde duloksetin başlanmalıdır

Anahtar Kelimeler:

Fibromiyalji sendromu, kişilik özellikleri, pregabalin, duloksetin

The Investigation Effects of Pregabalin and Duloxetine Treatment According to Personality Characteristics Groupe with Fibromyalgia Patients

This study was to compare the effects of duloxetine and pregabalin on fibromyalgia(FMS)patients with different personalities. A total of 102 female with FMS who applied to outpatient clinics of the Department of PhysicalMedicine and Rehabilitation in Duzce University Medical School between October (2013)December (2014),were grouped according to their personality characteristics. Each personalitygroup was also randomly divided in two groups. One group received 60 mg/day duloxetine andthe other group received 300 mg/day pregabalin for 12 weeks.The pain intensity of the patientswas evaluated with VAS,their sleep quality was evaluated with VAS–sleep score,depression wasevaluated with Beck Depression Scale(BDS), quality of life was evaluated with SF-36, andfunctioning was evaluated with Fibromyalgia Impact Questionnaire(FIQ) before and aftertreatment. Thirty of the neurotic group received duloxetine, 31 received pregabalin while 20 of theextroverts received duloxetine and 21 received pregabalin.Significant improvements wereobtained in the neurotic-duloxetine and extroverted-pregabalin groups in terms of BDS andgeneral health perceptions dimension of SF-36. Significant improvements were observed in allgroups in terms of VAS,VAS-Sleep and sensitive points.The increase after treatment in physicalfunctioning,physical role functioning, vitality,mental health and bodily pain in SF-36 wassignificant in all groups.The increase in emotional role functioning was significantly higher inonly neurotic-duloxetine and neurotic–pregabalin groups.Whereas the effects of treatments werenot found statistically significant on vitality in all groups.The decrease in FIQ scores wassignificant in extroverted–duloxetine and extroverted–pregabalin groups. Treatment should be initiated with pregabalin in extroverts, and duloxetine in neurotics

Keywords:

Fibromyalgia, personality characteristics, pregabalin, duloxetine,

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