An update on pharmacotherapy for the treatment of fibromyalgia

  title={An update on pharmacotherapy for the treatment of fibromyalgia},
  author={Elena P Calandre and Fernando Rico-Villademoros and Mahmoud Slim},
  journal={Expert Opinion on Pharmacotherapy},
  pages={1347 - 1368}
Introduction: Fibromyalgia is a syndrome characterized by chronic generalized pain in addition to different symptoms such as fatigue, sleep disturbances, stiffness, cognitive impairment, and psychological distress. Multidisciplinary treatment combining pharmacological and nonpharmacological therapies is advised. Areas covered: Publications describing randomized controlled trials and long-term extension studies evaluating drug treatment for fibromyalgia were searched in PubMed and Scopus and… 

Amitriptyline for the treatment of fibromyalgia: a comprehensive review

Low doses of tricyclic antidepressant amitriptyline in low doses are effective for the treatment of fibromyalgia and, despite the limited quality of the data, they do not seem to be associated with relevant tolerability or safety issues.

Current and Emerging Pharmacotherapy for Fibromyalgia

Current clinical experience with different pharmacologic treatments used for fibromyalgia is summarized to introduce future perspectives in developing therapies and lead to new developments of novel tailor-made treatments for FMS patients.

Fibromyalgia: Treating Pain in the Juvenile Patient

More stringent randomized, controlled trials with longer follow-up periods are needed in order to determine the long-term efficacy and safety of medications in the treatment of JFMS.

Updated Treatment of Fibromyalgia Syndrome: A Review

Fibromyalgia is a debilitating condition that is frequently misdiagnosed. It affects 2% of the population, with middle-aged women having the highest frequency. Fibromyalgia affects more women than

Milnacipran for the Treatment of Fibromyalgia.

A more holistic approach is needed to treat fibromyalgia effectively and further research, including direct comparison studies, should be conducted to fully evaluate the usefulness of this drug.

Fibromyalgia Pathogenesis and Treatment Options Update

The most recent diagnostic criteria for fibromyalgia, as put forth by the American College of Rheumatology, will be summarized, and the evidence behind non-pharmacologic treatments, including massage therapy, exercise, and acupuncture, are discussed.

Combination pharmacotherapy for the treatment of fibromyalgia in adults.

A double-blind, randomised controlled trials comparing combinations of two or more drugs to placebo or other comparators for the treatment of fibromyalgia pain found some evidence that combination pharmacotherapy reduced pain compared to monotherapy.

Saffron (Crocus sativus) versus duloxetine for treatment of patients with fibromyalgia: A randomized double-blind clinical trial

Saffron and duloxetine demonstrated comparable efficacy in treatment of fibromyalgia symptoms and Hamilton Rating Scale for Depression, Fibromyalgia Impact Questionnaire, and Brief Pain Inventory.

Adding medical cannabis to standard analgesic treatment for fibromyalgia: a prospective observational study.

This observational study shows that adjunctive MCT offers a possible clinical advantage in FM patients, especially in those with sleep dysfunctions, and the clinical improvement inversely correlated with BMI.

Lidocaine in fibromyalgia: A systematic review

This study demonstrates the short-term effectiveness and safety of intravenous lidocaine in FM patients, however, more studies, including long-term follow-up, are still needed.



Current status of atypical antipsychotics for the treatment of fibromyalgia.

Overall, the use of quetiapine (initiated at a low dose and slowly titrated) in fibromyalgia should be limited to patients with comorbid major depression or patients who are currently receiving other treatments and have unresolved and disabling depressive and/or anxiety symptoms.

Monotherapy or Combination Therapy for Fibromyalgia Treatment?

Fibromyalgia is a chronic pain disease whose clinical symptomatology also includes different symptom domains: fatigue, sleep disturbances, morning stiffness, dyscognition, and psychological distress, which requires well-designed clinical trials exploring specific drug combinations selected on the basis of potential additive or synergistic effects.

Moclobemid treatment in primary fibromyalgia syndrome

It is concluded that moclobemid therapy is effective in relieving most of the symptoms of FMS compared with placebo.

The Role of Antidepressants in the Management of Fibromyalgia Syndrome

A quantitative analysis of the efficacy and harms of antidepressants in the management of adult FMS patients, using Cohen’s categories, found the effect size on pain was small and the ones on sleep, fatigue, depression and HRQOL were not substantial.

Treatment of Fibromyalgia Syndrome: Recommendations of Recent Evidence-Based Interdisciplinary Guidelines with Special Emphasis on Complementary and Alternative Therapies

It is indicated that there is no single ideal treatment for fibromyalgia syndrome (FMS) and first choice treatment options remain debatable, especially concerning the importance of complementary and alternative medicine (CAM) treatments.

Adjuvant use of melatonin for treatment of fibromyalgia

Administration of melatonin, alone or in a combination with fluoxetine, was effective in the treatment of patients with FMS.

Serotonin and noradrenaline reuptake inhibitors (SNRIs) for fibromyalgia syndrome.

The SNRIs duloxetine and milnacipran provided a small incremental benefit over placebo in reducing pain and sleep problems, and did not improve QOL substantially.

Management of fibromyalgia syndrome – an interdisciplinary evidence-based guideline

A guideline for the management of fibromyalgia syndrome was developed by 13 German medical and psychological associations and two patient self-help organisations to provide patients and physicians guidance in selecting among the alternatives.

Efficacy of milnacipran in patients with fibromyalgia.

In this Phase II study, milnacipran led to statistically significant improvements in pain and other symptoms of FM, the effect sizes were equal to those previously found with TCA, and the drug was generally well tolerated.