Pharmacotherapy for patients with fibromyalgia.
Fibromyalgia is a common and disabling syndrome. Despite research detailing the efficacy of a variety of medicinal treatments, most notably, tricyclic antidepressants, serotonin-norepinephrine re-uptake inhibitors, and alpha(2)delta ligands, there is still widespread, routine use of agents that are mostly ineffective in treating the central nature of fibromyalgic pain. This article discusses pharmacotherapeutic options for fibromyalgia, including those with high-level evidence for efficacy, moderate-level evidence, and little or no evidence for efficacy. The importance of an integrated treatment approach that includes pharmacotherapy and at least one, but preferably more, of the most effective nonmedicinal treatment options available (e.g., education, aerobic exercise, and cognitive-behavioral therapy) is also discussed.
Division of Rheumatology, Department of Internal Medicine, and Michigan Institute for Clinical and Health Research, University of Michigan Medical School, Ann Arbor, USA. dclauw@umich.edu
Daniel J
DJ
Clauw
D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy; D015444:Exercise; D005260:Female; D005356:Fibromyalgia / Q000188:drug therapy* / Q000628:therapy; D006801:Humans; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D014147:Tramadol / Q000627:therapeutic use
D000701:Analgesics, Opioid; D014151:Anti-Anxiety Agents; D000929:Antidepressive Agents, Tricyclic; D017367:Selective Serotonin Reuptake Inhibitors; D014147:Tramadol