ABSTRACT
Forty-seven patients with definite rheumatoid arthritis (RA) were treated in a 32 week, double blind, crossover trial of amitriptyline, desipramine, trazodone, and placebo. All drug regimens produced significant changes on pain measures relative to baseline, but only amitriptyline exceeded placebo. Amitriptyline was associated with a significant reduction in the number of painful/tender joints. Our study supports the efficacy of a moderate dose of amitriptyline as an adjunct drug for the treatment of pain in both depressed and nondepressed patients with RA.
Subject(s)
Antidepressive Agents/therapeutic use , Arthritis, Rheumatoid/drug therapy , Pain/drug therapy , Aged , Amitriptyline/therapeutic use , Antidepressive Agents/administration & dosage , Arthritis, Rheumatoid/complications , Depression/drug therapy , Desipramine/therapeutic use , Double-Blind Method , Drug Therapy, Combination , Female , Humans , Male , Middle Aged , Random Allocation , Trazodone/therapeutic useABSTRACT
Operationalized diagnostic criteria for depression were used to assess 137 (76% male, 24% female) patients with rheumatoid arthritis (RA). Forty-two percent met criteria for some form of depression. Discriminant function analysis revealed a significant relationship between the presence or history of depression and higher levels of pain, but not between current depression and common indicators of RA activity or severity. These results suggest that depression is a frequent disorder among persons with RA. The importance of patient appraisal of disease and assessment of repeated depressive episodes is discussed. Attention to specific interventions for depression in conjunction with the treatment of the RA is suggested.
