Drug therapy.
Because of the lack of understanding of the basis of fibromyalgia, therapy remains empiric. This article reviews the different drug elements used in fibromyalgia, including psychotropic agents (antidepressants, sedatives and hypnotics), anti-inflammatories, analgesics and other pharmacological compounds. The strength of evidence for the therapeutic effect of each medicinal modality is presented, with the emphasis on results of randomized controlled trials. The importance of the expected effects of the current drug modalities, and whether these drugs have short- or long-term effects, are also discussed. Future directions, including testing of newer antidepressants, analgesics and non-steroidal anti-inflammatory drugs (Cox-2 selective inhibitors), as well as the need for long-term comparative trials of both drug efficacy and toxicity, are discussed.
Buskila
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Rheumatic Disease Unit, Soroka Medical Center, Beer Sheva, Israel.
D000700:Analgesics / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D005356:Fibromyalgia / Q000188:drug therapy*; D006801:Humans; D017063:Outcome Assessment, Health Care; D011619:Psychotropic Drugs / Q000627:therapeutic use*
D000700:Analgesics; D000893:Anti-Inflammatory Agents; D011619:Psychotropic Drugs