Pharmacological treatment of fibromyalgia and other chronic musculoskeletal pain.
The pharmacologic management of fibromyalgia is based on the emerging evidence that pain in this disorder is primarily related to central pain sensitization. There is strong evidence that tricyclic antidepressants are effective, and moderate evidence for the effectiveness of serotonin reuptake inhibitors and dual serotonin-norepinephrine reuptake inhibitors. Recent work suggests that the anti-seizure medications pregabalin and gabepentin are also effective. The only analgesic demonstrated to be helpful is tramadol.
Goldenberg
Don L
DL
Newton-Wellesley Hospital, Division of Rheumatology, Newton, MA 02468, USA. dgoldenb@massmed.org
D018759:Adrenergic Uptake Inhibitors / Q000627:therapeutic use; D000588:Amines / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000927:Anticonvulsants / Q000627:therapeutic use*; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use; D005356:Fibromyalgia / Q000188:drug therapy*; D000077206:Gabapentin; D006801:Humans; D010146:Pain / Q000188:drug therapy*; D000069583:Pregabalin; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D014147:Tramadol / Q000627:therapeutic use; D016896:Treatment Outcome; D005680:gamma-Aminobutyric Acid / Q000031:analogs & derivatives / Q000627:therapeutic use
D018759:Adrenergic Uptake Inhibitors; D000588:Amines; D000701:Analgesics, Opioid; D000927:Anticonvulsants; D000929:Antidepressive Agents, Tricyclic; D003509:Cyclohexanecarboxylic Acids; D000077206:Gabapentin; D000069583:Pregabalin; D017367:Selective Serotonin Reuptake Inhibitors; D014147:Tramadol; D005680:gamma-Aminobutyric Acid