title: Duloxetine and pregabalin for pain management in multiple rheumatic diseases associated with fibromyalgia.
abstract: The fibromyalgia syndrome (FMS) is characterized by chronic and widespread musculoskeletal pain and soreness accompanied by sleep disorders, chronic fatigue and affective disorders. FMS is often associated with other forms of immuno-rheumatic diseases. Although FMS pathophysiology is still not fully understood, a number of neuroendocrine, neurotransmission and neurosensitive disorders might generate a mechanism for the elicitation of pain by "central sensitization," which is common to many other painful conditions. The present case describes the success of a therapeutic scheme, which associates two different pharmacological classes, anticonvulsants and new-generation antidepressants, when FMS complicates a rare pathology called Cogan's syndrome. The association of two drugs might noticeably affect the molecular mechanisms of difficult pain, thus solving painful conditions of multifactorial origin.
authors.affiliation: Anesthesiology and Pain Medicine, Department of Health Sciences, University of L'Aquila, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Angeletti
authors.forename: Cristiana
authors.initials: C
authors.lastname: Guetti
authors.forename: Alba
authors.initials: A
authors.lastname: Piroli
authors.forename: Paolo Matteo
authors.initials: PM
authors.lastname: Angeletti
authors.forename: Antonella
authors.initials: A
authors.lastname: Paladini
authors.forename: Alessandra
authors.initials: A
authors.lastname: Ciccozzi
authors.forename: Franco
authors.initials: F
authors.lastname: Marinangeli
authors.forename: Giustino
authors.initials: G
authors.lastname: Varrassi
mesh_terms: D000700:Analgesics / Q000627:therapeutic use*; D015897:Comorbidity; D000068736:Duloxetine Hydrochloride; D005260:Female; D005356:Fibromyalgia / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D000069583:Pregabalin; D012216:Rheumatic Diseases / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D013876:Thiophenes / Q000627:therapeutic use*; D005680:gamma-Aminobutyric Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000700:Analgesics; D013876:Thiophenes; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid; D000068736:Duloxetine Hydrochloride
keywords: Cogan's syndrome; anticonvulsant; antidepressant; drugs association; fibromyalgia; pain management; rheumatological diseases