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The effect of guided imagery and amitriptyline on daily fibromyalgia pain.

15 Aug

The effect of guided imagery and amitriptyline on daily fibromyalgia pain: a prospective, randomized, controlled trial.

A Norwegian research team compared the effects of attention distracting imagery, attention focusing imagery and amitriptyline (elavil and similar anti-depressants) on fibromyalgia pain in 55 women. They monitored them daily for pain in a randomized, controlled clinical trial. One group (n=17) received relaxation training and “pleasant” guided imagery designed to distract them from their pain. Another group (n=21) received relaxation training and attention imagery that focused on the "active workings of the internal pain control systems”. The control group received treatment as usual (n=17). Patients were also randomly assigned to 50-mg amitriptyline/day or placebo. The slopes of diary pain ratings over a 4-week period were used as the outcome measures. The team found significant differences of the pain-slopes between the three psychological conditions (P=0.0001). The pleasant imagery declined significantly (P<0.005) when compared with the control group (P>0.05). The attention imagery group''s slope did not. Neither was there a difference between the amitriptyline and placebo slopes (main effects, P=0.98). The study concludes that pleasant imagery is an effective intervention in reducing fibromyalgic pain during the 28-day study period. Amitriptyline had no significant advantage over placebo during the study period.

Citation: Fors EA, Sexton H, Gotestam KG. The effect of guided imagery and amitriptyline on daily fibromyalgia pain: a prospective, randomized, controlled trial. Journal of Psychiatry Research 2002 May-Jun;36(3):179-87

Belleruth Naparstek

Psychotherapist, author and guided imagery pioneer Belleruth Naparstek is the creator of the popular Health Journeys guided imagery audio series. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award