AB0950 EFFECT OF SELECTIVE SEROTONIN REUPTAKE INHIBITORS AND SEROTONIN NOREPINEPHRINE REUPTAKE INHIBITORS ON BONE MINERAL DENSITY IN EGYPTION PATIENTS WITH PRIMARY FIBROMYALGIA

Abstract

Objective: Fibromyalgia is characterized by chronic widespread musculoskeletal pain that often co-exists with sleep disturbances, fatigue, cognitive dysfunction, stiffness and tenderness to palpation at specific tender points. Selective serotonin reuptake inhibitors (SSRIs) represent a class of commonly used antidepressants. They act by preventing the reuptake of 5-hydroxytryptamine (5-HT) (serotonin) through the inhibition of the 5-HT transporter (5-HTT) which is located on the presynaptic neuron, thereby increasing levels of 5-HT within the synaptic cleft and modulating neurochemical signaling. Usage of SSRIs was significantly associated with lumbar spine BMD reduction, particularly for old people. This study aimed to determine the correlation between SSRIs and serotonin norepinephrine reuptake inhibitors (SNRIs) usage and BMD and trabecular bone score (TBS) changes in primary fibromyalgia patient. Method(s): The present cross-sectional study was conducted on 100 Egyptian patients diagnosed as primary fibromyalgia divided according to drug medication into 2 groups, 50 patients on SSRIs and 50 patients on SNRIs, recruited from Rheumatology, Physical Medicine and Rehabilitation Departments at AlHussein and Sayed Galal, Al-Azhar University Hospitals. In addition to another 50 age matched the control group subdivided into 25 primary fibromyalgia patients not on those drugs and 25 healthy individuals selected by nurses and medical staff, after an informed consent from all subjects from June 2018 to December 2018. An approval was obtained from the medical ethics committee of Al-Azhar University before starting this study. All the patients were informed about the study procedures and a written consent was obtained from all of them. The subjects were categorized into three groups. Group A: 50 1ry fibromyalgia patients on SSRI. Group B: 50 1ry fibromyalgia patients on SNRI. Group C: 50 individuals as a the control group subdivided into: group C-1: 25, 1ry fibromyalgia patients non SRIsusers and group C-2: 25 healthy individuals. Result(s): DXA and TBS revealed that usage of SSRIs and SNRI was significantly associated with low BMD (osteopenia and osteoporosis) specially spine BMD reduction with low TBS (partially degraded and degraded) particularly for old people. Conclusion(s): The present study provided evidence that usage of SSRIs or SNRI was significantly associated with low BMD (osteopenia and osteoporosis) specially spineBMD reduction with low TBS (partially degraded and degraded) particularly for old people and despite low BMD was found in the SRI users; it also found in 1ry fibromyalgia not on SRIs so 1ry fibromyalgia should also be considered as a contributing factor for low BMD.