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Abstract Number: 1108

Methylphenidate Improves Concentration, Energy and Mood In Fibromyalgia

Robert S. Katz1, Hannah Bond2 and Frank Leavitt3, 1Rush Medical College, Chicago, IL, 2Rheumatology Associates, Chicago, IL, 3Rush University Medical Center, Chicago, IL

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: Cognitive dysfunction, fibromyalgia, medication, pain and treatment options

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Session Information

Title: Fibromyalgia, Soft Tissue Disorders and Pain II

Session Type: Abstract Submissions (ACR)

Background/Purpose: Central nervous system stimulants such as methylphenidate appear to have short term benefits for naming speed and cognitive functioning in fibromyalgia (FMS).  Methylphenidate quickly allows patients with FMS to operate at a more normal pace in naming words and broadly improves cognitive functioning.  The present study addresses the question of whether the benefits of methylphenidate extend to concentration, energy and feelings of well-being that are often found with treatment of ADHD.    

Methods: Interference from pain on energy, mood and concentration was  measured on a 10 point visual analogue scale, with endpoint of one indicating that pain does not interfere, and 10 indicating that pain completely interferes.  The four measures were administered to 48 patients with FMS, before receiving methylphenidate and post methylphenidate.  The FMS patients were female, met the new ACR criteria for FMS. Methylphenidate dosage was clinically determined and ranged from 10 to 60 mg.  The median methylphenidate usage at retesting was 30 days. 

Results: The mean age of the FMS sample was 48.3±12.3 years.  Table 1 shows test performance at the pretest and posttest sessions. A repeated measures ANOVA showed significant reduction in pain interference on energy (p<0.01), concentration (p<0.001) and mood (p<0.05).  The largest change occurred with concentration.   

 Conclusion:  Methylphenidate, a primary treatment for attention deficit hyperactivity disorder (ADHD), was helpful in alleviating some of the problems patients with fibromyalgia have with concentration, energy and mood.  The parallel treatment results underscore the possibility of a link between ADHD and fibromyalgia.  In a previous investigation of linkage, adult symptoms of ADHD and FMS were found to co-occur more frequently than might be expected by chance.  However, as a group, FMS patients satisfying criteria for ADHD in adulthood were not abnormally inattentive or disinhibited in childhood.  The likelihood that ADHD in FMS has its onset in childhood is minimal. Energy, concentration and mood can be improved in fibromyalgia by the administration of methylphenidate.


Disclosure:

R. S. Katz,
None;

H. Bond,
None;

F. Leavitt,
None.

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