Pharmacotherapy of fibromyalgia

Traynor, Laura M.; Thiessen, Christopher N.; Traynor, Andrew P.
July 2011
American Journal of Health-System Pharmacy;7/15/2011, Vol. 68 Issue 14, p1307
Academic Journal
Purpose. Published evidence on the pathophysiology, diagnosis, and treatment of fibromyalgia is reviewed, with an emphasis on recent clinical trials of various pharmacologic agents. Summary. Fibromyalgia affects an estimated 2% of the general U.S. population, and its incidence is sevenfold higher among women. The diagnostic characteristics of fibromyalgia are chronic widespread pain, thought to arise from abnormalities of ascending pain and descending inhibitory sensory pathways, and allodynia on palpation of specific tender points. Three medications available in the United States are labeled for treatment of fibromyalgia-related symptoms: the serotonin- and norepinephrine-reuptake inhibitors duloxetine and milnacipran and the a2-d ligand pregabalin. Evidence from clinical trials indicates that all three drugs can have a significant impact on fibromyalgia-related pain; duloxetine and pregabalin have been demonstrated to reduce sleep disturbances and improve quality of life (the former also has been shown to improve mood), while milnacipran can offer significant benefits in reducing fatigue. A growing body of evidence suggests that the best treatment approach may involve the use of one or more agents whose mechanisms of action are aligned with patient-specific clusters of symptoms. Several other agents have been used for fibromyalgia, with mixed results, including tricyclic antidepressants, selective serotonin-reuptake inhibitors, opioids, and gabapentin. Given the limitations of the evidence from clinical trials to date, controlled trials directly comparing different agents are needed to better delineate adverse-event risks, cost considerations, and optimal management approaches. Conclusion. A broad range of drugs has been used to treat fibromyalgia. Symptoms, comorbidities, adverse effects, and patient preference are important considerations in drug selection.


Related Articles

  • Schizophrenia and other Psychotic Disorders.  // Current Medical Literature: Psychiatry;2010, Vol. 21 Issue 4, p123 

    The author comments on several articles about schizophrenia and other psychotic disorders. According to the author, the article by S. P. Singh et al. suggests that the combined antidepressants and antipsychotic medications are more effective compared to antipsychotics plus placebo in treating...

  • Antidepressant Use During Breastfeeding. Berle, Jan Øystein; Spigset, Olav // Current Women's Health Reviews;Feb2011, Vol. 7 Issue 1, p28 

    Background: The treatment of breastfeeding mothers with depression raises several dilemmas, including the possible risk of drug exposure through breast milk for the infant. This article provides background information and presents practical advice and recommendations for the clinician dealing...

  • Increased Psychiatric Morbidity Before and After the Diagnosis of Hypothyroidism: A Nationwide Register Study. Thvilum, Marianne; Brandt, Frans; Almind, Dorthe; Christensen, Kaare; Brix, Thomas Heiberg; Hegedüs, Laszlo // Thyroid;May2014, Vol. 24 Issue 5, p802 

    Background: Thyroid hormones are necessary for fetal brain development, and hypothyroidism in adults has been associated with mood symptoms and reduced quality of life. Nevertheless, our knowledge regarding the association and temporal relation between hypothyroidism and mental disorders is...

  • Metabolic Abnormalities Are Implicated in Pediatric Cyclic Vomiting Syndrome. Jones, Ariel // Neurology Reviews;Oct2011, Vol. 19 Issue 10, p15 

    The article reports on the study on the role of metabolic abnormalities in pediatric cyclic vomiting syndrome, presented at the 53rd Annual Meeting of the American Headache Society in Washington, D.C. in 2011. It says that the said abnormalities are common to children with cyclic vomiting...

  • News Capsules. Increased awareness, better drug therapies drive mental health medication use. Talsma, Julia // Formulary;Mar2012, Vol. 47 Issue 3, p89 

    The article discusses a report titled "America's State of Mind Report," which was written by physician David Muzina of the Medco Neuroscience Therapeutic Resource Center and published by Medco Health Solutions Inc. In the report Muzina suggests that since 2001 in the U.S. there has been an...

  • Osteogenesis imperfecta associated with recurrent depressive episodes and postpartum psychosis in a 27-year-old women. Koch, Horst J.; Bauer, Andreas // Archives of Psychiatry & Psychotherapy;Dec2012, Vol. 14 Issue 4, p59 

    A 27-year-old woman was admitted to a psychiatric ward due to acute postpartum psychosis. The patient suffered from both recurrent depressive episodes with histrionic traits for years and osteogenesis imperfecta type I according to Sillence. As the patient and her monozygotic twin, also...

  • Drug-induced acute akathisia.  // Australian Prescriber;Dec2010, Vol. 33 Issue 6, p184 

    The article provides information on the acute drug-induced akathisia, a common extrapyramidal side effect experienced by patients taking typical or atypical antipsychotics and antidepressants, particularly when administrated poorly. In minimising the risk of akathisia, avoiding polypharmacy and...

  • Treatment options of delusional parasitosis: case series of 14 patients. COŞAR, Behçet; TAŞKINOĞLU, Kardem; LEPPING, Peter; BURHANOĞLU, Sabri; YAPICI ESER, Hale; TANER, Mustafa Ender; ARIKAN, Zehra // Anatolian Journal of Psychiatry / Anadolu Psikiyatri Dergisi;Sep2012, Vol. 13 Issue 3, p239 

    Objective: Delusional parasitosis (DP) is a rare psychiatric disorder in which patients develop the delusional belief that they are infested by parasites. Second generation antipsychotics and antidepressants can be used for its treatment. Traditionally the first generation antipsychotic pimozide...

  • Editor's Message. Issue Highlights, January 2011. Kalali, Amir // Innovations in Clinical Neuroscience;Jan2011, Vol. 8 Issue 1, p3 

    An introduction to the journal is presented in which the editor discusses various reports published within the issue including the role of N-acetyl-cysteine in mental health, the measurement of the functional capacity in schizophrenia, and the significance of attention deficits with regards to...

  • A review of medicines that affect sexual performance. Mkele, Gail // South African Pharmaceutical Journal;2014, Vol. 81 Issue 4, p34 

    Medicine-induced sexual dysfunction is an adverse effect that is relatively common, and yet is poorly understood. Several classes of medicine cause or contribute to sexual dysfunction in both men and women. Sexual dysfunction attributed to the use of medicine can be a major cause of nonadherence...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics