Use of antidepressants for treatment of depression, pain, fatigue, and sleep in multiple sclerosis.

TitleUse of antidepressants for treatment of depression, pain, fatigue, and sleep in multiple sclerosis.
Publication TypeJournal Article
AuthorsBamer AM, Warner V, Johnson KL
JournalMultiple Sclerosis

Background: Individuals with multiple sclerosis (MS) often experience a variety of symptoms related to their disease, including depression, pain, fatigue, and difficulties sleeping. A previous study found that 35% of individuals with MS report taking antidepressant medications, though reasons for taking these medications could have been unrelated to depressive symptoms. Objective: To examine prevalence of current use of antidepressant medications and explore alternative reasons for antidepressant use in a community sample of individuals with MS. Methods: A self-report cross sectional survey of 487 community-dwelling individuals with MS in Washington State assessed current use of 20 different antidepressant medications including selective serotonin reuptake inhibitors (SSRIs) and buproprion. Individuals were also asked to report whether the medications were used to help manage their depression, pain, fatigue, sleep, or if unsure. Participants were allowed to indicate if the medication was being used to manage more than one symptom. Results: 236 individuals (48%) reported current use of at least one antidepressant medication. Of these, 71% (n=168) reported using it for treatment of depression, 20% for pain (n=47), 29% (n=68) for sleep management, 11% (n=27) for fatigue, and 2% (n=5) were unsure. The majority of individuals on antidepressants were taking SSRIs and/or buproprion. Antidepressant medications most often indicated as being used for pain were amitriptyline, duloxetine, and nortiptyline. Those most often used for sleep were trazodone and amitriptyline and the only one commonly used for fatigue was buproprion. Conclusions: Use of antidepressants is higher here than in some previous reports. Participants report that antidepressant medications have been prescribed for conditions other than depression making it difficult to isolate the prescription practices related to depression itself.

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