Monday, 24 June 2013

A treatment for depression in MS

Are you depressed? You may be interested in this post. #MSBlog #MSResearch

Epub: Solaro et al. Duloxetine Is Effective in Treating Depression in Multiple Sclerosis Patients: An Open-Label Multicenter Study. Clin Neuropharmacol. 2013 Jun 17.

OBJECTIVES: Duloxetine hydrochloride, a dual reuptake inhibitor of serotonin and norepinephrine, was evaluated for its therapeutic efficacy, safety, and tolerability in the treatment of depression in MSers. Lifetime depression prevalence approaches 50% in MSers.The aim of the study was to assess the safety and efficacy of duloxetine for treatment of depression in MSers.

METHODS: An open-label study evaluated the efficacy of 12 weeks of duloxetine administration (maximal dose = 60 mg/d) in MSers with clinical depression. The Beck scale score variation after 4 (T1) and 12 (T2) weeks of treatment was used for the primary outcome measurement, whereas secondary outcome was measured using the Modified Fatigue Impact Scale. Safety was evaluated by recording treatment-related adverse events, monitoring vital signs, and recording frequency and reasons for interruption or discontinuation of treatment.

RESULTS: Seventy-five MSers were enrolled in the study. Sixty-three MSers completed the study by continuing duloxetine treatment for 12 weeks (T2). Twelve subjects dropped out of the study because of adverse effects or noncompliance. Nausea was the most common adverse event reported. A significant reduction in the Beck Depression Inventory and Modified Fatigue Impact Scale scores, after both 4 and 12 weeks of therapy, was observed.

CONCLUSIONS: The results suggest that duloxetine is well tolerated, safe, and effective in reducing depression and fatigue in MSers.


"This study simply demonstrates what a problem depression is in MSers and that a treatment Duloxetine, may be beneficial."

"I have uploaded the Beck Depression Inventory for you so that you can complete it yourself. If  you find you are depressed you need to see your neurological team or general practitioner to seek advice. There are non-pharmacological treatments for depression that work as well, and in some cases better, than medication, e.g. cognitive behavioural therapy (CBT).  Exercise and other brain health activities also help with depression."

"Sorry, about the barrage of bad news; it seems to come in cycles. However, please remember that we are on the cusp of a paradigm shift in the treatment of MS. I just hope the wider community accepts the paradigm."

2 comments:

  1. Some of the questions impinge upon MS symptoms and could give a misleading assessment, eg I feel more tired than I used to - this could be an effect of fatigue and/or the need to expend more energy or take more equipment such as a wheelchair to achieve something. Just a thought.

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    Replies
    1. This is one of the reasons why I don't like using the Beck Inventory. I prefer the HAD (Hospital Anxiety and Depression) scale.

      http://www.sandbachgps.nhs.uk/uploaded_files/files/ashfields/HADS.pdf

      It is copyrighted so I can't upload it myself.

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