Effect of Intravenous Lidocaine Associated With Amitriptyline on Pain Relief and Plasma Serotonin, Norepinephrine, and Dopamine Concentrations in Fibromyalgia

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Vlainich, Roberto [UNIFESP]
Issy, Adriana Machado [UNIFESP]
Sakata, Rioko Kimiko [UNIFESP]
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Objective: the objective of this study was to evaluate the effect of intravenous lidocaine combined with amitriptyline on pain relief and plasma serotonin, norepinephrine, and dopamine levels.Methods: A prospective, randomized, double-blind comparative study was conducted in 30 patients. All patients received 25mg amitriptyline; monotherapy group (n=15) received 125mL saline, and combined therapy group (n=15) received 240mg lidocaine in 125mL saline once a week for 4 weeks. Serotonin, norepinephrine, and dopamine were measured in plasma at time zero (T0) and after 4 weeks (T4). Pain intensity was rated on a numerical scale at the beginning of the study and weekly for 4 weeks.Results: All patients were females and the mean age was 44.7 +/- 10.5 years for monotherapy group and 40.9 +/- 11.6 years for combined therapy group. No difference in pain intensity at baseline was observed between groups, with a decrease after treatment in monotherapy group (T0: 7.0 +/- 1.2 and T4: 4.0 +/- 2.1) and in combined therapy group (T0: 7.6 +/- 0.8 and T4: 4.1 +/- 2.3). Plasma serotonin and norepinephrine levels were similar in the 2 groups at T0 and T4. An increase in dopamine levels was observed in monotherapy group from the beginning to the end of treatment.Conclusions: Combined administration of 240mg intravenous lidocaine (once a week) and 25 mg amitriptyline for 4 weeks did not modify pain intensity or plasma serotonin, norepinephrine, or dopamine concentrations in fibromyalgia patients.
Clinical Journal of Pain. Philadelphia: Lippincott Williams & Wilkins, v. 27, n. 4, p. 285-288, 2011.