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A comparison of dothiepin versus placebo in the treatment of pain in rheumatoid arthritis and the association of pain with depression.

Abstract
The effectiveness of dothiepin (a tricyclic anti-depressant) at a dose of 75 mg given orally at night was compared with placebo for 4 weeks in alleviating pain in 60 patients with classical or definite active rheumatoid arthritis. Patients were classified as either 'depressed' or 'not depressed'. The week before, during and 2 weeks after the study, 600 mg ibuprofen was given orally three times daily to all patients. Compared with placebo, dothiepin produced a significant reduction in daytime pain by the end of the treatment period. The Hamilton rating scale in 'depressed' patients was significantly improved in patients given dothiepin. The Cassano-Castrogiovanni self-evaluation rating scale in both 'depressed' and 'not depressed' patients showed a tendency (not significant) to be improved following dothiepin treatment compared with placebo. These results suggest that patients with rheumatoid arthritis may experience an increase in pain symptoms due to an alteration of mood. Therapy with tricyclic anti-depressants, such as dothiepin, therefore, may determine an improvement of pain indexes besides having an anti-depressant effect.
AuthorsP Sarzi Puttini, M Cazzola, L Boccassini, G Ciniselli, S Santandrea, I Caruso, C Benvenuti
JournalThe Journal of international medical research (J Int Med Res) 1988 Sep-Oct Vol. 16 Issue 5 Pg. 331-7 ISSN: 0300-0605 [Print] England
PMID3058537 (Publication Type: Clinical Trial, Controlled Clinical Trial, Journal Article, Randomized Controlled Trial)
Chemical References
  • Dibenzothiepins
  • Dothiepin
Topics
  • Arthritis, Rheumatoid (drug therapy)
  • Clinical Trials as Topic
  • Depressive Disorder (drug therapy)
  • Dibenzothiepins (therapeutic use)
  • Dothiepin (adverse effects, therapeutic use)
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain (drug therapy)

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