A meta-analysis of fibromyalgia treatment interventions.
OBJECTIVE
To evaluate and compare the efficacy of pharmacological and nonpharmacological treatments of fibromyalgia syndrome (FMS).


METHODS
This meta-analysis of 49 fibromyalgia treatment outcome studies assessed the efficacy of pharmacological and nonpharmacological treatment across four types of outcome measures-physical status, self-report of FMS symptoms, psychological status, and daily functioning.


RESULTS
After controlling for study design, antidepressants resulted in improvements on physical status and self-report of FMS symptoms. All nonpharmacological treatments were associated with significant improvements in all four categories of outcome measures with the exception that physically-based treatment (primarily exercise) did not significantly improve daily functioning. When compared, nonpharmacological treatment appears to be more efficacious in improving self-report of FMS symptoms than pharmacological treatment alone. A similar trend was suggested for functional measures.


CONCLUSIONS
The optimal intervention for FMS would include nonpharmacological treatments, specifically exercise and cognitive-behavioral therapy, in addition to appropriate medication management as needed for sleep and pain symptoms.
Rossy
L A
LA
Department of Psychology, University of Missouri, Columbia 65211, USA.
Buckelew
S P
SP
Dorr
N
N
Hagglund
K J
KJ
Thayer
J F
JF
McIntosh
M J
MJ
Hewett
J E
JE
Johnson
J C
JC
D000203:Activities of Daily Living; D015444:Exercise; D005356:Fibromyalgia / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D006304:Health Status; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000379:methods; D011613:Psychotherapy / Q000379:methods*; D011619:Psychotropic Drugs / Q000627:therapeutic use*
D011619:Psychotropic Drugs