Moclobemid treatment in primary fibromyalgia syndrome

Moclobemid is an antidepressant agent acting by reversible and preferential inhibition of the A-form of monoamine oxidase. In order to determine the efficacy of moclobemid in the treatment of fibromyalgia syndrome (FMS) a single blind placebo controlled randomized study was planned. 60 patients with FMS satisfying American College of Rheumatology (ACR) 1990 criteria of fibromyalgia classification were randomly defined to be treated with either 150 mg moclobemid twice daily or placebo for 6 weeks. Apart from either moclobemid or placebo treatment all patients received relaxation exercises by EMG-biofeedback training. Assessment parameters were tender point score, duration of morning stiffness in minutes, pain severity score and depression score. In addition each patient was asked to evaluate his fatigue and insomnia. Patients' and physicians' global assessments were also taken into consideration. In the moclobemid group, all outcome parameters were significantly improved compared with the baseline. The comparison of the progress in each parameter between the 2 groups showed that tender point, depression and pain scores were significantly more decreased, fatigue, insomnia, patients' and physicians' global assessments were also significantly more improved in moclobemid group. It is concluded that moclobemid therapy is effective in relieving most of the symptoms of FMS compared with placebo.