Burhan ADAK, Ali S. ÇİLLİ, İbrahim TEKEOĞLU, M. Yücel AĞARGÜN

Fibromiyalji sendromundaki uyku bozuklukları üzerine trazodonun etkisi

Amaç: Bu çalışmada fibromiyalji sendromunda (FMS) sık görülen ve etiyolojisinde suçlanan uyku bozukluklarının tedavisinde trazodonun etkinliğinin araştırılması hedef alındı. Yöntem: Uyku kalitesini ölçmek için Pittsburgh Uyku Kalitesi İndeksi (PUKİ) kullanıldı. Cinsiyet, yaş ve tedavi öncesi PUKİ değerleri açısından homojen olan 27 hastaya trazodon (50 mg/gün), 14 hastaya plasebo 3 hafta süreyle verildi. Kontrol PUKl değerlerindeki değişiklikler nonparametrik testlerle değerlendirildi. Bulgular: Trazodon ve plasebo grubunda başlangıç değerlerine göre uyku kalitesinin anlamlı derecede düzeldiği, plasebo grubuna göre trazodon grubundaki düşmenin anlamlı derecede daha fazla, kontrol PUKİ değerlerinin daha düşük olduğu bulundu. Sonuç: FMS'de özellikle uyku kalitesi şikayetleri üzerine trazodon plaseboya göre daha etkilidir.

Effect of trazodone versus on sleep abnormalities in fibromyalgia

Objective: This study was performed to investigate the effectiveness of trazodone in the treatment of sleep problems which were frequently seen with and blamed in the etiology of fibromyalgia syndrome (FMS). Methods: Pittsburgh Sleep Quality Inventory (PSQI) was used to assess the sleep quality of patients. Two groups (trazodone, n=27; placebo, n=14) matched with sex, age and initial PSQI scores were treated for 3 weeks. Trazodone was given 50 mg/day. Nonparametric tests were utilized to analyze the PSQI differences with treatment. Results: There was significant improvement in sleep quality both with trazodone and with placebo group, but the improvement was significantly higher with trazodone than with placebo, and after treatment PSQI scores was low with trazodone. Conclusion: Trazodone is more efficient than placebo, especially on sleep quality of patients with FMS.

PDF

___

May KP, West SG, Baker MR, Everett DW. Sleep apnea in male patients with the fibromyalgia syndrome. Am J Med 1993;94:505-8.
Branco J, Atalaia A, Paiva T. Sleep cycles and alpha-delta sleep in fibromyalgia syndrome. J Rheumatol 1994;21:1113-7.
Drewes AM, Nielsen KD, Taagholt SJ, Bjerregard K, Svendsen L, Gade J. Sleep intensity in fibromyalgia: Focus on the microstructure of the sleep process. Br J Rheumatol 1995;34:629-35.
Horne JA, Shackell BS. Alpha-like EEG activity in non-REM sleep and the fibromyalgia (fibrositis) syndrome. Electroencephalogr Clin Neurophysiol 1991;79:271-6.
Anch AM, Lue FA, MacLean AW, Moldofsky H. Sleep physiology and psychological aspects of the fibrositis (fibromyalgia) syndrome. Can J Psychol 1991;45:179-84.
Gupta MA, Moldofsky H. Dysthymic disorder and rheumatic pain modulation disorder (fibrositis syndrome): A comparison of symptoms and sleep physiology. Can J Psychiatry 1986;31:608-16.
Reynolds WJ, Moldofsky H, Saskin P, Lue FA. The effects of cyclobenzaprine on sleep physiology and symptoms in patients with fibromyalgia. J Rheumatol 1991;18:452-4.
Touchon J. Use of antidepressants in sleep disorders: Practical. Encephale 1995;7:41-7.
Goodnick PJ, Sandoval R. Psychotropic treatment of chronic fatigue syndrome and related disorders. J Clin Psychiatry 1993;54:13-20.
Regard J, Volkmann H, Danneskiold B. A randomized controlled trial of citalopram in the treatment of fibromyalgia. Pain 1995;61:445-9.
Carette S, Bell MJ, Reynolds WJ, Haraoui B, McCain GA, Bykerk VP, et al. Comparison of amitriptyline, cyclobenzaprine and placebo in the treatment of fibromyalgia: A randomized' double-blind clinical trial. Arthritis Rheum 1994;37:32-40.
Wolfe F. Fibromyalgia in the elderly: Differential diagnosis and treatment. Geriatrics 1988;43:57-68.
Quimby LG, Gratwick GM, Whitney CD, Block SR. A randomized trial of cyclobenzaprine for the treatment of fibromyalgia. J Rheumatol 1989;19 Suppl:140-3.
Reiffenberger DH, Amundson LH. Fibromyalgia syndrome: A review. Am Fam Physician 1996;53:1698-712.
Drewes AM, Andreasen A, Jennum P, Nielsen KD. Zopiclone in the treatment of sleep abnormalities in fibromyalgia. Scand J Rheumatol 1991;20:288-93.
Aşkın R. Depresyon el kitabı. Konya: Atlas Kitabevi; 1994.
Moldofsky H, Scarisbick P, England BA. Musculoskeletal symptoms and non-REM sleep disturbances in patients with fibrositis syndrome and healthy subjects. Psychosom Med 1975;37:341.
Gupta MA, Moldofsky H. Dysthymic disorder and rheumatic pain modulation disorder (fibrositis syndrome): A comparison of symptoms and sleep physiology. Can J Psychiatry 1986;31:608-16.
Alvarez Lario B, Teran J, Alonso JL, Alegre J, Arroyo I, Viejo JL. Lack of association between fibromyalgia and sleep apnea syndrome. Ann Rheum Dis 1992;51:108-11.