title: [Drug therapy of fibromyalgia syndrome. Systematic review, meta-analysis and guideline].
abstract: BACKGROUND
  The scheduled update to the German S3 guidelines on fibromyalgia syndrome (FMS) by the Association of the Scientific Medical Societies ("Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften", AWMF; registration number 041/004) was planned starting in March 2011.
  
  
  METHODS
  The development of the guidelines was coordinated by the German Interdisciplinary Association for Pain Therapy ("Deutsche Interdisziplinären Vereinigung für Schmerztherapie", DIVS), 9 scientific medical societies and 2 patient self-help organizations. Eight working groups with a total of 50 members were evenly balanced in terms of gender, medical field, potential conflicts of interest and hierarchical position in the medical and scientific fields.                          Literature searches were performed using the Medline, PsycInfo, Scopus and Cochrane Library databases (until December 2010). The grading of the strength of the evidence followed the scheme of the Oxford Centre for Evidence-Based Medicine. The recommendations were based on level of evidence, efficacy (meta-analysis of the outcomes pain, sleep, fatigue and health-related quality of life), acceptability (total dropout rate), risks (adverse events) and applicability of treatment modalities in the German health care system. The formulation and grading of recommendations was accomplished using a multi-step, formal consensus process. The guidelines were reviewed by the boards of the participating scientific medical societies.
  
  
  CONCLUSIONS
  Amitriptyline and-in case of comorbid depressive disorder or generalized anxiety disorder-duloxetine are recommended. Off-label use of duloxetine and pregabalin can be considered in case of no comorbid mental disorder. Strong opioids are not recommended.                         The English full-text version of this article is available at SpringerLink (under "Supplemental").
authors: Neurologische Klinik, Universitätsklinikum Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Deutschland. sommer@uni-wuerzburg.de
authors: C
authors: C
authors: Sommer
authors: W
authors: W
authors: Häuser
authors: R
authors: R
authors: Alten
authors: F
authors: F
authors: Petzke
authors: M
authors: M
authors: Späth
authors: T
authors: T
authors: Tölle
authors: N
authors: N
authors: Uçeyler
authors: A
authors: A
authors: Winkelmann
authors: E
authors: E
authors: Winter
authors: K J
authors: KJ
authors: Bär
mesh_terms: D000639:Amitriptyline / Q000627:therapeutic use; D000700:Analgesics / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology; D003131:Combined Modality Therapy; D015897:Comorbidity; D003299:Cooperative Behavior; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology; D000068736:Duloxetine Hydrochloride; D005356:Fibromyalgia / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D005858:Germany; D006801:Humans; D033183:Interdisciplinary Communication; D056687:Off-Label Use; D010348:Patient Care Team; D000069583:Pregabalin; D013001:Somatoform Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D013876:Thiophenes / Q000627:therapeutic use; D005680:gamma-Aminobutyric Acid / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid; D000928:Antidepressive Agents; D013876:Thiophenes; D000639:Amitriptyline; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid; D000068736:Duloxetine Hydrochloride