Prostatodynia
is a somatoform pain disorder, common and often
disabling, presenting with urogenital pain and
urinary symptoms, that affects males. Following
the absence of efficient treatment and the
positive result of an open pilot study with the
selective serotonin reuptake inhibitor (SSRI),
fluvoxamine, a more complete study has been
carried out with this compound.
In a double-blind trial, 42 men with
prostatodynia were randomised to treatment with
fluvoxamine (n = 21) or placebo (n = 21) for up
to 8 weeks. The dose of fluvoxamine was adjusted
as needed, the median dose being 150 mg (50-300
mg range). Measurements of self-rated pain
scores, urinary flow rates, depression and
anxiety scores were performed at baseline and
several times throughout the study.
An intent-to-treat analysis, showed that
fluvoxamine reduced pain intensity and
normalised urinary flow rates, in comparison
with placebo. However, affective ratings were
similar in both groups at the end of the study,
indicating that mood changes were not
responsible for these improvements. Final scores
on the General Health Questionnaire were lower
in the fluvoxamine-treated group, reflecting an
overall benefit from pain relief.
Although dose-ranging studies and longer trials
are recommended to support these findings, it is
clear that the SSRI, fluvoxamine is a helpful
treatment for patients with prostatodynia. J
Clin Psychiat 63: 778-781, 2002