Fluoxetine and Fibromyalgia

Abstract

<h3>To the Editor.—</h3> Fluoxetine hydrochloride (Prozac) is a new antidepressant characterized by selective inhibition of central nervous system neuronal up-take of serotonin.¹Fibromyalgia is a common, chronic, rheumatologic pain disorder that may respond to antidepressant treatment.²Only one patient with fibromyalgia has been reported to have been treated successfully with fluoxetine.³We describe two additional patients. <h3>Case 1.—</h3> A 41-year-old woman was diagnosed in 1987 as having fibromyalgia by the criteria of Yunus et al.⁴Over the past 3 years, response to trials of trazodone hydrochloride, nortriptyline hydrochloride, and doxepin hydrochloride had been poor. One week after adding 20 mg of fluoxetine hydrochloride every other day to 25 mg of doxepin hydrochloride every evening, the patient reported markedly decreased pain and increased energy, as well as moderately improved sleep. Three months later, she has maintained improvement of her symptoms by taking 20 mg of fluoxetine hydrochloride