Use of antidepressants in the treatment of chronic orofacial pain caused by temporomandibular disorders: A randomized controlled clinical trial

Bruno Macedo de Sousa; Antonio López-Valverde; Francisco Caramelo; Maria Joao Rodrigues; Nansi López-Valverde

doi:10.1016/j.medcli.2024.02.002

Use of antidepressants in the treatment of chronic orofacial pain caused by temporomandibular disorders: A randomized controlled clinical trial

Med Clin (Barc). 2024 Apr 2:S0025-7753(24)00128-3. doi: 10.1016/j.medcli.2024.02.002. Online ahead of print.

[Article in English, Spanish]

Authors

Bruno Macedo de Sousa¹, Antonio López-Valverde², Francisco Caramelo³, Maria Joao Rodrigues¹, Nansi López-Valverde⁴

Affiliations

¹ Institute for Occlusion and Orofacial Pain Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
² Department of Surgery, University of Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain.
³ Laboratory of Biostatistics and Medical Informatics, Coimbra, Institute for Clinical and Biomedical Research (iCBR), School of Medicine, University of Coimbra, Coimbra, Portugal.
⁴ Department of Surgery, University of Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain. Electronic address: nlovalher@usal.es.

PMID: 38570297
DOI: 10.1016/j.medcli.2024.02.002

Abstract

Background and objective: Temporomandibular disorders (TMDs) are a common pathology, associated with pain in the facial territory and with associated psychological disorders, such as anxiety and depression. The aim of this study was to evaluate the efficacy of antidepressants in the treatment of pain associated with TMD.

Materials and methods: Sixty four patients suffering from chronic orofacial pain, randomly distributed in 3 groups: control group treated with night splint, group treated with 10mg/day of citalopram and group treated with 25mg/day of amitriptyline. Pain intensity was assessed, randomly, by a single blinded evaluator, according to the VAS at baseline and after one, three, six and nine weeks.

Results: All groups showed a reduction of pain throughout the period of time evaluated, however, the group treated with amitriptyline showed the best pain reduction results 3.3±1.5, 1.5±1.4 and 0.9±1.3 at 3, 6 and 9 weeks, respectively.

Conclusions: Low doses of amitriptyline appear to be a good therapeutic option in patients with TMDs suffering from chronic orofacial pain.

Keywords: Antidepresivos; Antidepressants; Dolor orofacial; Ensayo clínico aleatorizado; Orofacial pain; Randomized clinical trial; Temporomandibular disorders; Trastornos temporomandibulares.