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Fibromyalgia: Diagnosis and treatment options
Gender Medicine, 07/28/09

Marcus DA et al. – Review concludes that fibromyalgia is a common, disabling, chronic pain condition that predominantly affects women. Symptoms can be effectively treated using both drug and nondrug therapies; treatment benefits appear largely independent of patient sex.

• Review article to provide updated information from database literature on:
  • Fibromyalgia epidemiology, including gender differences
  • Psychological comorbidity, and
  • Treatment with medication and nonmedication therapies
• Literature review from Jan 2000 to Oct 2008 using the PubMed and EMBASE databases
• Search terms: fibromyalgia, exercise, gender, nonpharmacologic, placebo-controlled, randomized, and treatment

• New epidemiologic data support important differences in fibromyalgia symptom severity between the sexes and the important role of comorbid psychological distress
• Physicians diagnose fibromyalgia in women at an ~3- to 6-fold rate compared with men
• Clinical trials and treatment guidelines reinforce effective treatment with medication and nonpharmacologic therapy
• Strongest evidence suggests effective treatment of fibromyalgia with duloxetine and milnacipran
• Efficacy with gabapentin, pramipexole, pregabalin, tramadol, and IV tropisetron is also reported
• Nonpharmacologic treatments:
  • Fitness and strengthening exercise
  • Warm-water therapy, and
  • Psychological pain management techniques

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