(705): Psychotropic medication use among adolescents with juvenile fibromyalgia

Abstract

Juvenile primary fibromyalgia syndrome (JPFS) is a chronic condition characterized by widespread musculoskeletal pain. There are currently no clear guidelines for the treatment of adolescents with JPFS. As part of our ongoing research program, we are systematically gathering information about all patients referred to a pediatric rheumatology clinic for treatment of fibromyalgia-like symptoms. Of particular interest are the types of medications used to treat adolescents with JPFS as part of usual medical care. Of the 41 new patients with fibromyalgia-like symptoms referred to the clinic from January 2005-October 2005, 36 met the Yunus and Masi criteria for JPFS, and had these demographic characteristics: 94.4% female, average age 14.5 years, 88.9% Caucasian, 5.6% African-American, 5.6% other race/ethnicity. Pain duration ranged from 6 months through 9 years, with 58.3% reporting at least 2 years of pain. A number of different medications were used for pain relief: 10 patients were on non-steroidal anti-inflammatory drugs, 7 on muscle relaxants and 4 on acetaminophen. Use of psychotropic medication was common with 19 (52.8%) patients taking at least one medication (8 on a selective serotonin reuptake inhibitor, 8 on a tricyclic antidepressant, 2 on an anxiolytic medication, 2 on a stimulant and 1 on a mood stabilizer). Fourteen patients (38.9%) had been diagnosed with at least one psychiatric disorder (4 with anxiety, 7 with depression, 1 with bipolar disorder, 3 with attention-deficit hyperactivity disorder, 2 with Asperger’s disorder). The most commonly prescribed medications for adolescents with JPFS, even those without a psychiatric diagnosis, were antidepressants. Although evidence from adult clinical trials suggests that these medications can be useful for fibromyalgia, there have been no pediatric trials that have tested potentially effective treatments for JPFS. The results of this study indicate a critical need for evidence-based clinical guidelines for the treatment of JPFS. Juvenile primary fibromyalgia syndrome (JPFS) is a chronic condition characterized by widespread musculoskeletal pain. There are currently no clear guidelines for the treatment of adolescents with JPFS. As part of our ongoing research program, we are systematically gathering information about all patients referred to a pediatric rheumatology clinic for treatment of fibromyalgia-like symptoms. Of particular interest are the types of medications used to treat adolescents with JPFS as part of usual medical care. Of the 41 new patients with fibromyalgia-like symptoms referred to the clinic from January 2005-October 2005, 36 met the Yunus and Masi criteria for JPFS, and had these demographic characteristics: 94.4% female, average age 14.5 years, 88.9% Caucasian, 5.6% African-American, 5.6% other race/ethnicity. Pain duration ranged from 6 months through 9 years, with 58.3% reporting at least 2 years of pain. A number of different medications were used for pain relief: 10 patients were on non-steroidal anti-inflammatory drugs, 7 on muscle relaxants and 4 on acetaminophen. Use of psychotropic medication was common with 19 (52.8%) patients taking at least one medication (8 on a selective serotonin reuptake inhibitor, 8 on a tricyclic antidepressant, 2 on an anxiolytic medication, 2 on a stimulant and 1 on a mood stabilizer). Fourteen patients (38.9%) had been diagnosed with at least one psychiatric disorder (4 with anxiety, 7 with depression, 1 with bipolar disorder, 3 with attention-deficit hyperactivity disorder, 2 with Asperger’s disorder). The most commonly prescribed medications for adolescents with JPFS, even those without a psychiatric diagnosis, were antidepressants. Although evidence from adult clinical trials suggests that these medications can be useful for fibromyalgia, there have been no pediatric trials that have tested potentially effective treatments for JPFS. The results of this study indicate a critical need for evidence-based clinical guidelines for the treatment of JPFS.