The use of opioids in fibromyalgia

@article{Ngian2011TheUO,
  title={The use of opioids in fibromyalgia},
  author={G. S. Ngian and Emma K. Guymer and Geoffrey Owen Littlejohn},
  journal={International Journal of Rheumatic Diseases},
  year={2011},
  volume={14}
}
Fibromyalgia syndrome (FMS) is a chronic disorder of widespread pain with high personal and societal burdens. Although targeted pharmacotherapies have become available in recent years, it remains a challenging condition to treat. Despite no randomized controlled trials addressing the short‐ or long‐term use of opioids in FMS, their use remains prevalent. In this article we discuss the role of opioids and other analgesics in the management of FMS, with particular focus on problems associated… 
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77 Citations

Chronic opioid use in fibromyalgia syndrome: a clinical review.
  • J. Painter, L. Crofford
  • Medicine
    Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases
  • 2013
TLDR
The case is made that chronic opioid use is inappropriate in the treatment of fibromyalgia (FM) syndrome because of the interaction of unique pathophysiologic characteristics of the patients and effects associated with chronic opioids use.
Opioid Use in Fibromyalgia: A Cautionary Tale.
Is there a role for opioids in the treatment of fibromyalgia?
TLDR
There is no evidence that pure opioids are effective in fibromyalgia but there is some evidence that opioids with additional actions on the norepinephrine-related pain modulatory pathways, such as tramadol, can be clinically useful in some patients.
Update on Treatment Guideline in Fibromyalgia Syndrome with Focus on Pharmacology
TLDR
Amitriptyline, Pregabalin and Duloxetine are used most commonly in FMS and though modestly effective, are useful adjunctive treatment to non-pharmaceutical measures.
CHRONIC OPIOID USE IN FIBROMYALGIA SYNDROME: CHARACTERISTICS AND OUTCOMES
TLDR
The impact of the interaction of chronic opioid use with fibromyalgia, despite control for myriad regressors, is significant both statistically and clinically.
Management of Fibromyalgia Syndrome: Review of Evidence
TLDR
Treatment options for managing fibromyalgia symptoms are reviewed, including FDA-approved medications and other pharmacologic agents, and non-pharmacologic treatments that have shown promising effects.
Fibromyalgia: Treating Pain in the Juvenile Patient
TLDR
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.
Opioid Use in Fibromyalgia Continues Despite Guidelines That Do Not Support Its Efficacy or Risk
TLDR
Greater burden of illness appeared to be associated with the prescription and use of opioids in this population of fibromyalgia patients, suggesting that some providers may not be aware of current recommendations that have been found to be effective in the management of FM that are contained in guidelines.
The current treatment of fibromyalgia O tratamento atual da fibromialgia
TLDR
Fibromyalgia therapy should be individualized, and it does not aim the cure; its objective is to reduce the subject’s suffering; provide function improvement and, as much as possible, the individual's autonomy and quality of life.
Healthcare Costs Associated With Chronic Opioid Use and Fibromayalgia Syndrome.
TLDR
While the differences seen in FM patients and controls are marginal, those attributed to chronic opioid use in these patients are significantly higher.
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