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Recent Advances in the Treatment of Pain Associated With Fibromyalgia
U.S. Pharmacist, 09/22/09

Nickerson B – Fibromyalgia is a common and disabling syndrome with pain being the primary presenting symptom and pain relief the principal concern of patients. Once a diagnosis has been established, it is important to select appropriate pharmacologic treatment. TCAs are generally considered first–line therapy; however, if they are ineffective or intolerable due to side effects, there are more options now than ever before. The development of new drugs for fibromyalgia is the result of a better understanding of the chronic pain mechanisms involved in this condition. Clinical studies have demonstrated the effectiveness of therapies targeting central pain mechanisms, such as alpha2–delta ligands (gabapentin, pregabalin) and SNRIs (duloxetine, milnacipran). Once an effective pharmacologic treatment is found, it is imperative to pursue nonpharmacologic options such as education, exercise, and cognitive behavior therapies, because an integrated treatment plan will benefit patients more than just medications alone.

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