Effect of intravenous lidocaine associated with amitriptyline on pain relief and plasma serotonin, norepinephrine, and dopamine concentrations in fibromyalgia

Abstract

Objective: The objective of this study was to evaluate the effect of intravenous lidocaine combined with amitriptyline on pain relief and plasma serotonin, norepinephrine, and dopamine levels.

Methods: A prospective, randomized, double-blind comparative study was conducted in 30 patients. All patients received 25 mg amitriptyline; monotherapy group (n=15) received 125 mL saline, and combined therapy group (n=15) received 240 mg lidocaine in 125 mL saline once a week for 4 weeks. Serotonin, norepinephrine, and dopamine were measured in plasma at time zero (T0) and after 4 weeks (T4). Pain intensity was rated on a numerical scale at the beginning of the study and weekly for 4 weeks.

Results: All patients were females and the mean age was 44.7±10.5 years for monotherapy group and 40.9±11.6 years for combined therapy group. No difference in pain intensity at baseline was observed between groups, with a decrease after treatment in monotherapy group (T0: 7.0±1.2 and T4: 4.0±2.1) and in combined therapy group (T0: 7.6±0.8 and T4: 4.1±2.3). Plasma serotonin and norepinephrine levels were similar in the 2 groups at T0 and T4. An increase in dopamine levels was observed in monotherapy group from the beginning to the end of treatment.

Conclusions: Combined administration of 240 mg intravenous lidocaine (once a week) and 25 mg amitriptyline for 4 weeks did not modify pain intensity or plasma serotonin, norepinephrine, or dopamine concentrations in fibromyalgia patients.