Fibromyalgia Syndrome: A Discussion of the Syndrome and Pharmacotherapy

  title={Fibromyalgia Syndrome: A Discussion of the Syndrome and Pharmacotherapy},
  author={Howard S. Smith and Robert L. Barkin},
  journal={American Journal of Therapeutics},
Fibromyalgia is a complex condition that is characterized by chronic widespread pain and multiple other symptoms, including fatigue, sleep disturbances, cognitive dysfunction, stiffness, and depressive episodes. Fibromyalgia may coexist and/or overlap with other conditions that may involve central sensitivity, including chronic fatigue syndrome, irritable bowel syndrome, irritable bladder syndrome or interstitial cystitis, and temporomandibular disorder. The pathophysiology of fibromyalgia… 
Pharmacotherapy for Fibromyalgia
The potential theories that possibly contribute to the pathogenesis of FM will be discussed, and a clinical algorithm will be presented for the step-wise management of pain and other associated symptoms of FM.
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.
Myofascial Pain Syndrome and Fibromyalgia
Both myofascial pain syndrome and fibromyalgia are clinical entities that involve the musculoskeletal system producing significant pain and suffering, and both conditions are primarily diagnosed clinically.
Pregabalin for the treatment of fibromyalgia
This review addresses pregabalin pharmacokinetics, efficacy and adverse event (AE) profiles from randomized controlled trials and open-label extension studies in patients with FM and raises questions on the generalizability of the RCT findings to the typical patient seen in clinical practice.
Milnacipran for fibromyalgia: a useful addition to the treatment armamentarium
Milnacipran provides modest fibromyalgia pain relief and is best used as part of a multidisciplinary treatment approach and may be a wise choice for Fibromyalgia patients with depressive symptoms and patients for whom sedation, dizziness, edema or weight gain with gabapentin and pregabalin is a problem.
Duloxetine: A Review of Its Safety and Efficacy in the Management of Fibromyalgia Syndrome
Suggestions for a therapeutic niche for duloxetine in FM are discussed based on a presentation of the characteristics of duloxin, which is classified pharmacologically as a serotonin-norepinephrine reuptake inhibitor.
An update on pharmacotherapy for the treatment of fibromyalgia
None of the currently available drugs are fully effective against the whole spectrum of fibromyalgia symptoms, namely pain, fatigue, sleep disturbances and depression, among the most relevant symptoms.
Chronic Tension Type Headache, An Analog for Fibromyalgia and Depression Disorder?
The patients with CTTH had similar patterns of memory damage and changes of the HPA and HPT axes, GnRH and pro-inflammatory cytokines with the FM and MDD patients.
Current Issues Regarding the Care of the Fibromyalgia Patient
In order to address the potential shortcomings of pharmacotherapy related to prescribing, poor response rates, and patient dissatisfaction, it becomes very important to incorporate a combination of both pharmacological and non-pharmacological approaches.


Fibromyalgia syndrome: review of clinical presentation, pathogenesis, outcome measures, and treatment.
  • P. Mease
  • Medicine, Psychology
    The Journal of rheumatology. Supplement
  • 2005
The multifaceted nature of FM suggests that multimodal individualized treatment programs may be necessary to achieve optimal outcomes in patients with this syndrome.
Treatment of fibromyalgia syndrome with antidepressants: a meta-analysis.
Antidepressant medications are associated with improvements in pain, depression, fatigue, sleep disturbances, and health-related quality of life in patients with FMS.
Pregabalin for the treatment of fibromyalgia syndrome: results of a randomized, double-blind, placebo-controlled trial.
Pregabalin at 450 mg/day was efficacious for the treatment of FMS, reducing symptoms of pain, disturbed sleep, and fatigue compared with placebo and was well tolerated and improved global measures and health-related quality of life.
Women's health issues with fibromyalgia syndrome.
Patients with FMS deserve careful assessment for reproductive conditions and sleep-related functional disorders, and intervention testing specifically to alleviate sleep problems, low physical activity levels, and sexual dysfunction should be paramount.
Association between fibromyalgia and sexual dysfunction in women
The major findings showed that FM is associated with sexual dysfunction in women, with decreased sexual desire and arousal, decreased experience of orgasm, and increased pain with intercourse.
Biology and therapy of fibromyalgia. Genetic aspects of fibromyalgia syndrome
There is evidence that polymorphisms of genes in the serotoninergic, dopaminergic and catecholaminergic systems play a role in the etiopathology of fibromyalgia syndrome and other related syndromes.
Tender Points as Predictors of Distress and the Pharmacologic Management of Fibromyalgia Syndrome
Tender point pain ratings and counts predicted a small but significant amount of variance in distress, and pharmacotherapeutic management of fibromyalgia involves at least four rather distinct factors, one of which is related to tender points.
Psychological pain treatment in fibromyalgia syndrome: efficacy of operant behavioural and cognitive behavioural treatments
It is suggested that both OBT and CBT are effective in treating patients with FMS with some differences in the outcome measures specifically targeted by the individual treatments compared with an unstructured discussion group.
EULAR evidence-based recommendations for the management of fibromyalgia syndrome
Nine recommendations for the management of fibromyalgia syndrome were developed using a systematic review and expert consensus using a Delphi process.
A six-month randomized controlled trial of exercise and pyridostigmine in the treatment of fibromyalgia.
It is speculated that pyridostigmine (PYD) may have improved vagal tone, thus benefiting sleep and anxiety; this notion warrants further study.