Advisory Committee Chair
Jarred Younger
Advisory Committee Members
Burel Goodin
Sylvie Mrug
Timothy Ness
Robert Sorge
Document Type
Dissertation
Date of Award
2022
Degree Name by School
Doctor of Philosophy (PhD) College of Arts and Sciences
Abstract
Fibromyalgia (FM) is a debilitating chronic pain condition. Its pathophysiology is largely unknown, which has hindered the development of effective treatments. Central sensitization and neuroinflammation have been forwarded as models of FM pathophysiology, both of which indicate the antitussive drug dextromethorphan (DXM) as a potentially effective treatment. DXM is an N-Methyl-D-aspartic acid (NMDA)-receptor antagonist and microglial modulator with anti-neuroinflammatory properties at low doses. It is currently available for clinical use, but has not been tested as a treatment for FM at low dosages. The current study evaluated the effectiveness of DXM in treating FM-associated symptoms of pain, fatigue, cognitive problems, and mood abnormalities. In a single-blind, placebo-controlled crossover trial, fourteen women meeting 2010 American College of Rheumatology diagnostic criteria for FM received a placebo for five weeks, followed by 20mg of DXM daily for ten weeks, while providing twice-daily symptom reports. Daily symptom ratings during the placebo period were contrasted with ratings during the active treatment to determine whether DXM reduced FM symptom severity. Generalized pain ratings were 9.9 points lower (on a 0-100 scale) during DXM compared to placebo (b= -9.933, p=0.013), and maximum pain levels were 9.7 points lower during DXM treatment than during placebo (b= -9.657, p=0.016). There were iv marginal reductions of 5.3 points in depressive symptoms during DXM (b= -5.322, p=0.056), and no effects on fatigue or cognitive complaints. DXM may be a safe and effective alternative treatment option for FM.
Recommended Citation
Mueller, Stephanie Christina, "Low-Dose Dextromethorphan for the Treatment of Pain in Fibromyalgia: A Single-Blind Placebo-Controlled Crossover Trial" (2022). All ETDs from UAB. 635.
https://digitalcommons.library.uab.edu/etd-collection/635