Review of pharmacological therapies in fibromyalgia syndrome
1 Department of Internal Medicine I, Klinikum Saarbrücken, Winterberg 1, D-66119, Saarbrücken, Germany
2 Department Psychosomatic Medicine and Psychotherapy, Technische Universität München, Langerstr. 3, D-81675, München, Germany
3 Georgetown University Medical Center, Washington Hospital Center, 110 Irving Street, Washington, DC 20010, USA
4 Division of Rheumatology, McGill University Health Centre; Alan Edwards Pain Management Unit, McGill University Health Centre, Montreal H3G 1A4, Canada
5 Department of Neurology, University of Würzburg, Josef-Schneider-Str. 11, D-97080, Würzburg, Germany
Arthritis Research & Therapy 2014, 16:201 doi:10.1186/ar4441Published: 17 January 2014
This review addresses the current status of drug therapy for the management of fibromyalgia syndrome (FMS) and is based on interdisciplinary FMS management guidelines, meta-analyses of drug trial data, and observational studies. In the absence of a single gold-standard medication, patients are treated with a variety of drugs from different categories, often with limited evidence. Drug therapy is not mandatory for the management of FMS. Pregabalin, duloxetine, milnacipran, and amitriptyline are the current first-line prescribed agents but have had a mostly modest effect. With only a minority of patients expected to experience substantial benefit, most will discontinue therapy because of either a lack of efficacy or tolerability problems. Many drug treatments have undergone limited study and have had negative results. It is unlikely that these failed pilot trials will undergo future study. However, medications, though imperfect, will continue to be a component of treatment strategy for these patients. Both the potential for medication therapy to relieve symptoms and the potential to cause harm should be carefully considered in their administration.