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Wednesday, 29 June 2016

Most Common Disease of 50plus: The Clinical trials and Studies of Musculo-Skeletal disorders(MSDs) - Fibromyalgia Treatment - The Medications of Tricyclic antidepressants

Kyle J. Norton(Scholar, Master of Nutrients), all right reserved.
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

Musculoskeletal disorders (MSDs) are  medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. A community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home. Musculoskeletal pain was reported by 57% of those interviewed(1).

      Types of Musculo-Skeletal disorders in elder

1. Osteoarthritis
2. Gout
3. Rheumatoid Arthritis
4. Polymalagia Arthritis
5. Cervical myleopathy and spinal canal stenosis
6. Osteoporosis
7. Low back pain
8. Fibromyalgia

                                                      Fibromyalgia

Fibromyalgia, according to the American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia in the newly proposed criteria for the classification of fibromyalgia are 1) widespread pain in combination with 2) tenderness at 11 or more of the 18 specific tender point sites(a) as a result in responding to pressure.

                        The Treatment



In conventional medicine perspective
FM usually involves females, particular to women entering stage of menopause. But it is often diagnosed both in young as well as elderly individuals. Diagnosis of pediatric FMS is a lengthy and frustrated condition affecting children and adolescents physical and emotional development, as the disease mimicked a spectrum of inflammatory joint disorders such as juvenile idiopathic arthritis (JIA), juvenile ankylosing spondylitis, etc, according to the study by Soroka Medical Center, Beer-Sheva(193)
A.2. Medications
2. Tricyclic antidepressants (if neuropathic, back or fibromyalgia pain) or tramadol; 
Fibromyalgia pain due to psychological syndrome may be treated with ricyclic antidepressants, a synthetic version of antidepressants such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs) and norepinephrine reuptake inhibitors (NRIs) through by blocking the serotonin transporter (SERT) and the norepinephrine
 transporter (NET)(215).  The medication through clinical expression have shown effectively for major treatment and management of fibromyalgia and other chronic pain syndromes(216).
. Dr. Lawson K said, "Tricyclic antidepressants are the most effective drugs in use so far, especially when administered in combination with other therapies (e.g., selective serotonin re-uptake inhibitors), which suggests modulation of the neurotransmitters serotonin and noradrenaline"(215).
Duloxetine, in 2 randomized, placebo-controlled, double-blind, parallel-group, 12-week trials of duloxetine in the treatment of fibromyalgia, has been shown to be an effective and safe treatment for attenuation of symptoms associated with fibromyalgia, particularly for women(217).

Most Common side effects, according to the Mayo Clinic, may include Dry mouth. Blurred vision. Constipation. Urinary retention. Drowsiness. Increased appetite leading to weight gain. .....(218)

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References
(215) Tricyclic antidepressants and fibromyalgia: what is the mechanism of action? by Lawson K1.(PubMed)
(216) A guide to the understanding and use of tricyclic antidepressants in the overall management of fibromyalgia and other chronic pain syndromes by Godfrey RG1.(PubMed)
(217) Duloxetine and other antidepressants in the treatment of patients with fibromyalgia by Arnold LM1.(PubMed)
(218) Side effects of Tricyclic antidepressants (TCAs) by Mayo Clinic