Parkinson’s disease (PD) patients who also have fibromyalgia (FM) tend to be younger, are often women, and are more likely to have a mental health condition like depression or anxiety, a population-based study conducted in Israel reports.
In this “subgroup,” Parkinson’s also looks more resistant to treatments, researchers say, noting that its members tend to use a greater number of different antiparkinson medications.
The study, “Fibromyalgia-Like Syndrome Associated with Parkinson’s Disease—A Cohort Study,” was published in the Journal of Clinical Medicine.
Detecting FM when it associates with other diseases is important, according to the researchers, as this helps doctors decide on better treatment strategies to address both conditions.
Some scientists have suggested that there is an association between fibromyalgia (FM) and Parkinson’s disease (PD). Both conditions share some clinical, and possibly some disease mechanisms, involving muscle and joint stiffness, unusual pelvic and rectal discomfort, poor sleep, fatigue, and depression.
Despite these overlapping symptoms, to date only one case report has described a patient with both PD and FM. That shows the need to characterize this group of patients, the researchers say.
To fill this gap, a team from the Soroka University Medical Center, in Israel, conducted a retrospective study investigating people diagnosed with both PD and FM. The team used an insurance database covering a large part of the population living in Israel between 2000 and 2015.
They identified 2,606 people with a definite Parkinson’s diagnosis, and from these, 60 (2.3%) who also were diagnosed with fibromyalgia.
Most of the patients with both conditions were females (88.3%), and their mean age at FM diagnosis was approximate 64 years. The majority (76.7%) were first diagnosed with PD, and only after that with FM.
Compared with patients who only had Parkinson’s disease, those who also had FM were more commonly affected by depression, anxiety, and dementia. They also tended to be younger, and were more likely to be women. Those with PD and FM also were less associated with high blood pressure (hypertension) or heart failure.
Regarding medication use, people with Parkinson’s and fibromyalgia were heavier users of differing kinds of painkillers, such as opioids and dipyrone. They also used more antidepressants, including selective serotonin reuptake inhibitors, called SSRIs, and serotonin–norepinephrine reuptake inhibitors, or SNRIs.
FM patients also purchased a greater amount of different types of antiparkinson medications — about 21.3% more than those with PD who did not have fibromyalgia. This suggests that the presence of FM is somewhat associated with a more difficult-to-treat Parkinson’s.
“We suggest that patients with PD + FM represent a distinct subgroup with a fibromyalgia-like syndrome associated with Parkinson’s disease (FLISPAD). Their PD is more treatment resistant, and they take more medications, both analgesics and anti-PD,” the researchers said.
“These patients present a challenge for physicians as they use more analgesics, psychotropic medications, and tend to also use more APDs [antiparkinson drugs] over time. More research is needed to determine the etiology and determinants of this syndrome, the needs of patients and course of treatment, both for PD and FM symptoms,” they concluded.