Drugs

, Volume 70, Issue 1, pp 1–14 | Cite as

Pharmacological Treatment of Fibromyalgia Syndrome

New Developments
Leading Article

Abstract

Fibromyalgia is a chronic pain disorder characterized by widespread pain, stiffness, insomnia, fatigue and distress. Several randomized controlled trials (RCTs) have shown moderate effectiveness of pharmacological therapies for fibromyalgia pain. Evidence from these trials suggests that pharmacological therapy can not only improve pain but also fatigue, function and well-being in patients with fibromyalgia. Duloxetine and milnacipran, two highly selective serotonin-norepinephrine (noradrenaline) reuptake inhibitors, and the α2δ agonist pregabalin have been approved by the US FDA for the treatment of fibromyalgia symptoms. In general, about half of all treated patients seem to experience a 30% reduction of symptoms, suggesting that many patients with fibromyalgia will require additional therapies. Thus, other forms of treatment, including exercise, cognitive behavioural therapies and self-management strategies, may be necessary to achieve satisfactory treatment outcomes.

Despite promising results of pilot trials, RCTs with dopamine receptor agonists and sodium channel antagonists have so far been disappointing for patients with fibromyalgia. However, new pharmacological approaches for the treatment of fibromyalgia pain and insomnia using sodium oxybate appear to be promising.

References

  1. 1.
    Goldenberg DL, Burckhardt C, Crofford L. Management of fibromyalgia syndrome. JAMA 2004; 292(19): 2388–95PubMedCrossRefGoogle Scholar
  2. 2.
    Mease P. Fibromyalgia syndrome: review of clinical presentation, pathogenesis, outcome measures, and treatment. J Rheumatol 2005; 32 Suppl. 75: 6–21Google Scholar
  3. 3.
    Wolfe F, Smythe HA, Yunus MB, et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia: report of the Multicenter Criteria Committee. Arthritis Rheum 1990; 33(2): 160–72PubMedCrossRefGoogle Scholar
  4. 4.
    Yunus MB. Symptoms and signs of fibromyalgia syndrome: an overview. In: Wallace DJ, Clauw DJ, editors. Fibromyalgia and other central pain syndromes. Philadelphia (PA): Lippincott, Williams & Wilkins, 2005: 125–32Google Scholar
  5. 5.
    Wolfe F, Michaud K. Severe rheumatoid arthritis (RA), worse outcomes, comorbid illness, and sociodemographic disadvantage characterize RA patients with fibromyalgia. J Rheumatol 2004; 31(4): 695–700PubMedGoogle Scholar
  6. 6.
    Wolfe F, Ross K, Anderson J, et al. The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheum 1995; 38(1): 19–28PubMedCrossRefGoogle Scholar
  7. 7.
    White KP, Speechley M, Harth M, et al. The London Fibromyalgia Epidemiology Study: the prevalence of fibromyalgia syndrome in London, Ontario. J Rheumatol 1999; 26(7): 1570–6PubMedGoogle Scholar
  8. 8.
    Lindell L, Bergman S, Petersson IF, et al. Prevalence of fibromyalgia and chronic widespread pain. Scand J Prim Health Care 2000; 18(3): 149–53PubMedCrossRefGoogle Scholar
  9. 9.
    Topbas M, Cakirbay H, Gulec H, et al. The prevalence of fibromyalgia in women aged 20–64 in Turkey. Scand J Rheumatol 2005; 34(2): 140–4PubMedGoogle Scholar
  10. 10.
    Forseth KO, Gran JT. The prevalence of fibromyalgia among women aged 20–49 years in Arendal, Norway. Scand J Rheumatol 1992; 21(2): 74–8PubMedCrossRefGoogle Scholar
  11. 11.
    Scudds RA, Li EKM, Scudds RJ. The prevalence of fibromyalgia syndrome in Chinese people in Hong Kong. J Musculoskelet Pain 2006; 14(2): 3–11CrossRefGoogle Scholar
  12. 12.
    Staud R, Nagel S, Robinson ME, et al. Enhanced central pain processing of fibromyalgia patients is maintained by muscle afferent input: a randomized, double-blind, placebo controlled trial. Pain 2009; 145: 96–104PubMedCrossRefGoogle Scholar
  13. 13.
    McLean SA, Williams DA, Harris RE, et al. Momentary relationship between cortisol secretion and symptoms in patients with fibromyalgia. Arthritis Rheum 2005; 52(11): 3660–9PubMedCrossRefGoogle Scholar
  14. 14.
    Neeck G, Crofford LJ. Neuroendocrine perturbations in fibromyalgia and chronic fatigue syndrome. Rheum Dis Clin North Am 2000; 26(4): 989–1002PubMedCrossRefGoogle Scholar
  15. 15.
    Carville SF, Arendt-Nielsen L, Bliddal H, et al. EULAR evidence based recommendations for the management of fibromyalgia syndrome. Ann Rheum Dis 2008; 67: 536–41PubMedCrossRefGoogle Scholar
  16. 16.
    Farrar JT, Young JP, LaMoreaux L, et al. Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain 2001; 94(2): 149–58PubMedCrossRefGoogle Scholar
  17. 17.
    Stutts LA, Robinson ME, McCulloch RC, et al. Patient centered outcome criteria for successful treatment of facial pain and fibromyalgia. J Orofac Pain 2009; 23(1): 47–53PubMedGoogle Scholar
  18. 18.
    Harris RE, Williams DA, McLean SA, et al. Characterization and consequences of pain variability in individuals with fibromyalgia. Arthritis Rheum 2005; 52(11): 3670–4PubMedCrossRefGoogle Scholar
  19. 19.
    Price DD, Patel R, Robinson ME, et al. Characteristics of electronic visual analogue and numeric scales for ratings of experimental pain in healthy subjects and fibromyalgia patients. Pain 2008; 140: 158–66PubMedCrossRefGoogle Scholar
  20. 20.
    Jensen MP, Karoly P, O’Riordan EF, et al. The subjective experience of acute pain: an assessment of the utility of 10 indices. Clin J Pain 1989; 5(2): 153–9PubMedCrossRefGoogle Scholar
  21. 21.
    Price DD, Bush FM, Long S, et al. A comparison of pain measurement characteristics of mechanical visual analogue and simple numerical rating scales. Pain 1994; 56(2): 217–26PubMedCrossRefGoogle Scholar
  22. 22.
    Staud R, Vierck CJ, Robinson ME, et al. Overall fibromyalgia pain is predicted by ratings of local pain and pain related negative affect: possible role of peripheral tissues. Rheumatology 2006; 45(11): 1409–15PubMedCrossRefGoogle Scholar
  23. 23.
    Melzack R. The short-form McGill Pain Questionnaire. Pain 1987; 30(2): 191–7PubMedCrossRefGoogle Scholar
  24. 24.
    Beck AT, Beamesderfer A. Assessment of depression: the depression inventory. In: Pichot P, editor. Psychological measurements in psychopharmacology. Basel: Karger, 1974: 151–69Google Scholar
  25. 25.
    Spielberger CD, Gorsuch RL, Lushene R, et al. Manual for the State-Trait Anxiety Inventory: STAI (self-evaluation questionnaire). Palo Alto (CA): Consulting Psychologists Press, 1983Google Scholar
  26. 26.
    Stone AA, Broderick JE, Schwartz JE, et al. Intensive momentary reporting of pain with an electronic diary: reactivity, compliance, and patient satisfaction. Pain 2003; 104(1–2): 343–51PubMedCrossRefGoogle Scholar
  27. 27.
    Burckhardt CS, Clark SR, Bennett RM. The fibromyalgia impact questionnaire: development and validation. J Rheumatol 1991; 18(5): 728–33PubMedGoogle Scholar
  28. 28.
    Bennett R. The Fibromyalgia Impact Questionnaire (FIQ): a review of its development, current version, operating characteristics and uses. Clin Exp Rheumatol 2005; 23(5): S154–62PubMedGoogle Scholar
  29. 29.
    Ware Jr J, Kosinski M. SF-36 physical & mental health summary scales: a manual for users of version 1. 2nd ed. Lincoln (RI): Quality Metric Incorporated, 1994Google Scholar
  30. 30.
    Deluze C, Bosia L, Zirbs A, et al. Electroacupuncture in fibromyalgia: results of a controlled trial. BMJ 1992; 305(6864): 1249–52PubMedCrossRefGoogle Scholar
  31. 31.
    Harris RE, Tian X, Williams DA, et al. Treatment of fibromyalgia with formula acupuncture: investigation of needle placement, needle stimulation, and treatment frequency. J Altern Complement Med 2005; 11(4): 663–71PubMedCrossRefGoogle Scholar
  32. 32.
    Assefi NP, Sherman KJ, Jacobsen C, et al. A randomized clinical trial of acupuncture compared with sham acupuncture in fibromyalgia. Ann Intern Med 2005; 143(1): 10–9PubMedGoogle Scholar
  33. 33.
    Brattberg G. Connective tissue massage in the treatment of fibromyalgia. Eur J Pain 1999; 3(3): 235–44PubMedCrossRefGoogle Scholar
  34. 34.
    Almeida TF, Roizenblatt S, Benedito-Silva AA, et al. The effect of combined therapy (ultrasound and interferential current) on pain and sleep in fibromyalgia. Pain 2003; 104(3): 665–72PubMedCrossRefGoogle Scholar
  35. 35.
    Buskila D, Abu-Shakra M, Neumann L, et al. Balneotherapy for fibromyalgia at the Dead Sea. Rheumatol Int 2001; 20(3): 105–8PubMedCrossRefGoogle Scholar
  36. 36.
    Williams DA. Utility of cognitive behavioral therapy as a treatment for insomnia in patients with fibromyalgia. Nat Rev Rheumatol 2006; 2(4): 190–1Google Scholar
  37. 37.
    Cedraschi C, Desmeules J, Rapiti E, et al. Fibromyalgia: a randomised, controlled trial of a treatment programme based on self management. Ann Rheum Dis 2004; 63(3): 290–6PubMedCrossRefGoogle Scholar
  38. 38.
    Chodosh J, Morton SC, Mojica W, et al. Meta-analysis: chronic disease self-management programs for older adults. Ann Intern Med 2005; 143(6): 427–38PubMedGoogle Scholar
  39. 39.
    McCain GA, Bell DA, Mai FM, et al. A controlled study of the effects of a supervised cardiovascular fitness training program on the manifestations of primary fibromyalgia. Arthritis Rheum 1988; 31(9): 1135–41PubMedCrossRefGoogle Scholar
  40. 40.
    Mannerkorpi K, Nyberg B, Ahlmen M, et al. Pool exercise combined with an education program for patients with fibromyalgia syndrome: a prospective, randomized study. J Rheumatol 2000; 27(10): 2473–81PubMedGoogle Scholar
  41. 41.
    Assis MR, Silva LE, Alves AMB, et al. A randomized controlled trial of deep water running: clinical effectiveness of aquatic exercise to treat fibromyalgia. Arthritis Rheum 2006; 55(1): 57–65PubMedCrossRefGoogle Scholar
  42. 42.
    Gusi N, Tomas-Carus P, Hakkinen A, et al. Exercise in waist-high warm water decreases pain and improves health-related quality of life and strength in the lower extremities in women with fibromyalgia. Arthritis Rheum 2006; 55(1): 66–73PubMedCrossRefGoogle Scholar
  43. 43.
    Valkeinen H, Hakkinen K, Pakarinen A, et al. Muscle hypertrophy, strength development, and serum hormones during strength training in elderly women with fibromyalgia. Scand J Rheumatol 2005; 34(4): 309–14PubMedCrossRefGoogle Scholar
  44. 44.
    Valkeinen H, Alen M, Hakkinen A, et al. Effects of concurrent strength and endurance training on physical fitness and symptoms in postmenopausal women with fibromyalgia: a randomized controlled trial. Arch Phys Med Rehabil 2008; 89(9): 1660–6PubMedCrossRefGoogle Scholar
  45. 45.
    Gowans SE, deHueck A, Voss S, et al. A randomized, controlled trial of exercise and education for individuals with fibromyalgia. Arthritis Care Res 1999; 12(2): 120–8PubMedCrossRefGoogle Scholar
  46. 46.
    Donmez A, Karagulle MZ, Tercan N, et al. SPA therapy in fibromyalgia: a randomised controlled clinic study. Rheumatol Int 2005; 26(2): 168–72PubMedCrossRefGoogle Scholar
  47. 47.
    Jones KD, Adams D, Winters-Stone K, et al. A comprehensive review of 46 exercise treatment studies in fibromyalgia (1988–2005). Health Qual Life Outcomes 2006; 4: 67–73PubMedCrossRefGoogle Scholar
  48. 48.
    Russell IJ, Perkins AT, Michalek JE. Sodium oxybate relieves pain and improves function in fibromyalgia syndrome: a randomized, double-blind, placebo-controlled, multicenter clinical trial. Arthritis Rheum 2009; 60(1): 299–309PubMedCrossRefGoogle Scholar
  49. 49.
    Goldenberg DL. Update on the treatment of fibromyalgia. Bull Rheum Dis 2004; 53(1): 1–7Google Scholar
  50. 50.
    Arnold LM, Keck Jr PE, Welge JA. Antidepressant treatment of fibromyalgia: a meta-analysis and review. Psychosomatics 2000; 41(2): 104–13PubMedCrossRefGoogle Scholar
  51. 51.
    O’Malley PG, Balden E, Tomkins G, et al. Treatment of fibromyalgia with antidepressants A meta-analysis. J Gen Intern Med 2000; 15(9): 659–66PubMedCrossRefGoogle Scholar
  52. 52.
    Anderberg UM, Marteinsdottir I, Von-Knorring L. Citalopram in patients with fibromyalgia: a randomized, double-blind, placebo-controlled study. Eur J Pain 2000; 4(1): 27–35PubMedCrossRefGoogle Scholar
  53. 53.
    Ozerbil O, Okudan N, Gokbel H, et al. Comparison of the effects of two antidepressants on exercise performance of the female patients with fibromyalgia. Clin Rheumatol 2006; 25(4): 495–7PubMedCrossRefGoogle Scholar
  54. 54.
    Mico JA, Ardid D, Berrocoso E, et al. Antidepressants and pain. Trends Pharmacol Sci 2006; 27(7): 348–54PubMedCrossRefGoogle Scholar
  55. 55.
    Evren B, Evren C, Guler MH. An open clinical trial of venlafaxine in the treatment of pain, depressive and anxiety symptoms in fibromyalgia. The Pain Clinic 2006; 18(2): 167–73CrossRefGoogle Scholar
  56. 56.
    Arnold LM, Lu YL, Crofford LJ, et al. A double-blind, multicenter trial comparing duloxetine with placebo in the treatment of fibromyalgia patients with or without major depressive disorder. Arthritis Rheum 2004; 50(9): 2974–84PubMedCrossRefGoogle Scholar
  57. 57.
    Russell J, Mease PJ, Smith TR, et al. Efficacy and safety of duloxetine for treatment of fibromyalgia in patients with or without major depressive disorder: results from a 6-month, randomized, double-blind, placebo-controlled, fixed-dose trial. Pain 2008; 136: 431–44CrossRefGoogle Scholar
  58. 58.
    Hauser W, Bernardy K, Uceyler N, et al. Treatment of fibromyalgia syndrome with antidepressants: a meta-analysis. JAMA 2009; 301(2): 198–209PubMedCrossRefGoogle Scholar
  59. 59.
    Tofferi JK, Jackson JL, O’Malley PG. Treatment of fibromyalgia with cyclobenzaprine: a meta-analysis. Arthritis Rheum 2004; 51(1): 9–13PubMedCrossRefGoogle Scholar
  60. 60.
    Childers MK, Borenstein D, Brown RL, et al. Low-dose cyclobenzaprine versus combination therapy with ibuprofen for acute neck or back pain with muscle spasm: a randomized trial. Curr Med Res Opin 2005; 21(9): 1485–93PubMedCrossRefGoogle Scholar
  61. 61.
    Vaeroy H, Abrahamsen A, Forre O, et al. Treatment of fibromyalgia (fibrositis syndrome): a parallel double blind trial with carisoprodol, paracetamol and caffeine (Somadril comp) versus placebo. Clin Rheumatol 1989; 8(2): 245–50PubMedCrossRefGoogle Scholar
  62. 62.
    Gallardo F, Molgo J, Miyazaki C, et al. Carisoprodol in the treatment of myofascial pain-dysfunction syndrome. J Oral Surg 1975; 33(9): 655–8PubMedGoogle Scholar
  63. 63.
    Xaio Y, Michalek JE, Russell IJ. Effects of tizanidine on cerebrospinal fluid substance P in patients with fibromyalgia. In: Saper JR, editor. Alpha-2 adrenergic agonists: evidence and experience examined. Worcester, UK: The Royal Society of Medicine Press, The Trinity Press, 2002: 23–8Google Scholar
  64. 64.
    Raffa RB, Friderichs E, Reimann W, et al. Opioid and nonopioid components independently contribute to the mechanism of action of tramadol, an ‘atypical’ opioid analgesic. J Pharmacol Exp Ther 1992; 260(1): 275–85PubMedGoogle Scholar
  65. 65.
    Tallarida RJ, Raffa RB. Testing for synergism over a range of fixed ratio drug combinations: replacing the isobologram. Life Sci 1996; 58(2): PL 23–8Google Scholar
  66. 66.
    Bennett RM, Kamin M, Karim R, et al. Tramadol and acetaminophen combination tablets in the treatment of fibromyalgia pain: a double-blind, randomized, placebo-controlled study. Am J Med 2003; 114(7): 537–45PubMedCrossRefGoogle Scholar
  67. 67.
    Russell IJ, Fletcher EM, Michalek JE, et al. Treatment of primary fibrositis/fibromyalgia syndrome with ibuprofen and alprazolam: a double-blind, placebo-controlled study. Arthritis Rheum 1991; 34(5): 552–60PubMedCrossRefGoogle Scholar
  68. 68.
    Wiffen P, Collins S, McQuay H, et al. Anticonvulsant drugs for acute and chronic pain. Cochrane Database Syst Rev 2005; (3): CD001133Google Scholar
  69. 69.
    Fishbain DA, Cutler RB, Rosomoff HL, et al. Clonazepam open clinical treatment trial for myofascial syndrome associated chronic pain. Pain Med 2000; 1(4): 332–9PubMedCrossRefGoogle Scholar
  70. 70.
    Rowbotham MC, Reisner-Keller LA, Fields HL. Both intravenous lidocaine and morphine reduce the pain of postherpetic neuralgia. Neurology 1991; 41(7): 1024–8PubMedCrossRefGoogle Scholar
  71. 71.
    Viola V, Newnham HH, Simpson RW. Treatment of intractable painful diabetic neuropathy with intravenous lignocaine. J Diabetes Complications 2006; 20(1): 34–9PubMedCrossRefGoogle Scholar
  72. 72.
    Edwards WT, Habib F, Burney RG, et al. Intravenous lidocaine in the management of various chronic pain states: a review of 211 cases. Regional Anaesthesia 1985; 10: 1–6Google Scholar
  73. 73.
    Sorensen J, Bengtsson A, Backman E, et al. Pain analysis in patients with fibromyalgia. Effects of intravenous morphine, lidocaine, and ketamine. Scand J Rheumatol 1995; 24(6): 360–5PubMedCrossRefGoogle Scholar
  74. 74.
    Bennett MI, Tai YM. Intravenous lignocaine in the management of primary fibromyalgia syndrome. Int J Clin Pharmacol Res 1995; 15(3): 115–9PubMedGoogle Scholar
  75. 75.
    Frank B, Niesler B, Bondy B, et al. Mutational analysis of serotonin receptor genes: HTR3A and HTR3B in fibromyalgia patients. Clin Rheumatol 2004; 23(4): 338–44PubMedCrossRefGoogle Scholar
  76. 76.
    Caruso I, Sarzi-Puttini P, Cazzola M, et al. Double-blind study of 5-hydroxytryptophan versus placebo in the treatment of primary fibromyalgia syndrome. J Int Med Res 1990; 18(3): 201–9PubMedGoogle Scholar
  77. 77.
    Yunus MB, Masi AT, Aldag JC. Short term effects of ibuprofen in primary fibromyalgia syndrome: a double blind, placebo controlled trial. J Rheumatol 1989; 16(4): 527–32PubMedGoogle Scholar
  78. 78.
    Goldenberg DL, Felson DT, Dinerman H. A randomized, controlled trial of amitriptyline and naproxen in the treatment of patients with fibromyalgia. Arthritis Rheum 1986; 29(11): 1371–7PubMedCrossRefGoogle Scholar
  79. 79.
    Clark S, Tindall E, Bennett RM. A double blind crossover trial of prednisone versus placebo in the treatment of fibrositis. J Rheumatol 1985; 12(5): 980–3PubMedGoogle Scholar
  80. 80.
    Moldofsky H, Lue FA, Mously C, et al. The effect of zolpidem in patients with fibromyalgia: a dose ranging, double blind, placebo controlled, modified crossover study. J Rheumatol 1996; 23(3): 529–33PubMedGoogle Scholar
  81. 81.
    Gronblad M, Nykanen J, Konttinen Y, et al. Effect of zopiclone on sleep quality, morning stiffness, widespread tenderness and pain and general discomfort in primary fibromyalgia patients: a double-blind randomized trial. Clin Rheumatol 1993; 12(2): 186–91PubMedCrossRefGoogle Scholar
  82. 82.
    Jensen TS. Anticonvulsants in neuropathic pain: rationale and clinical evidence. Eur J Pain 2002; 6 Suppl. A: 61–8PubMedCrossRefGoogle Scholar
  83. 83.
    Crofford LJ, Rowbotham MC, Mease PJ, et al. Pregabalin for the treatment of fibromyalgia syndrome: results of a randomized, double-blind, placebo-controlled trial. Arthritis Rheum 2005; 52(4): 1264–73PubMedCrossRefGoogle Scholar
  84. 84.
    Crofford LJ, Mease PJ, Simpson SL, et al. Fibromyalgia relapse evaluation and efficacy for durability of meaningful relief (FREEDOM): a 6-months, double-blind, placebo-controlled trial with pregabalin. Pain 2008; 136: 419–31PubMedCrossRefGoogle Scholar
  85. 85.
    Hauser W, Bernardy K, Uceyler N, et al. Treatment of fibromyalgia syndrome with gabapentin and pregabalin: a meta-analysis of randomized controlled trials. Pain 2009; 145(1–2): 69–81PubMedCrossRefGoogle Scholar
  86. 86.
    Arnold LM, Goldenberg DL, Stanford SB, et al. Gabapentin in the treatment of fibromyalgia: a randomized, double-blind, placebo-controlled, multicenter trial. Arthritis Rheum 2007; 56(4): 1336–44PubMedCrossRefGoogle Scholar
  87. 87.
    Iyengar S, Webster AA, Hemrick-Luecke SK, et al. Efficacy of duloxetine, a potent and balanced serotoninnorepinephrine reuptake inhibitor in persistent pain models in rats. J Pharmacol Exp Ther 2004; 311(2): 576–84PubMedCrossRefGoogle Scholar
  88. 88.
    Arnold LM, Rosen A, Pritchett YL, et al. A randomized, double-blind, placebo-controlled trial of duloxetine in the treatment of women with fibromyalgia with or without major depressive disorder. Pain 2005; 119(1-3): 5–15PubMedCrossRefGoogle Scholar
  89. 89.
    Arnold LM, Pritchett YL, D’Souza DN, et al. Duloxetine for the treatment of fibromyalgia in women: pooled results from two randomized, placebo-controlled clinical trials. J Womens Health 2007; 16(8): 1145–56CrossRefGoogle Scholar
  90. 90.
    Choy EHS, Mease PJ, Kajdasz DK, et al. Safety and tolerability of duloxetine in the treatment of patients with fibromyalgia: pooled analysis of data from five clinical trials. Clin Rheumatol 2009; 28(9): 1035–44PubMedCrossRefGoogle Scholar
  91. 91.
    Sayar K, Aksu G, Ak I, et al. Venlafaxine treatment of fibromyalgia. Ann Pharmacother 2003; 37(11): 1561–5PubMedCrossRefGoogle Scholar
  92. 92.
    Zijlstra TR, Barendregt PJ, van de Laar MA. Venlafaxine in fibromyalgia: results of a randomized, placebo-controlled, double-blind trial [abstract]. Arthritis Rheum 2002; 46: S105Google Scholar
  93. 93.
    Kranzler JD, Gendreau JF, Rao SG. The psychopharmacology of fibromyalgia: a drug development perspective. Psychopharmacol Bull 2002; 36(1): 165–213PubMedGoogle Scholar
  94. 94.
    Cipriani A. Review: selection serotonin reuptake inhibitors as effective as tricyclic antidepressants for major depression, and may have fewer adverse effects. Evid Based Ment Health 2003; 6(4): 117PubMedCrossRefGoogle Scholar
  95. 95.
    Vitton O, Gendreau M, Gendreau J, et al. A double-blind placebo-controlled trial of milnacipran in the treatment of fibromyalgia. Hum Psychopharmacol 2004; 19 Suppl. 1: S27–35PubMedCrossRefGoogle Scholar
  96. 96.
    Mease PJ, Clauw DJ, Gendreau RM, et al. The efficacy and safety of milnacipran for treatment of fibromyalgia: a randomized, double-blind, placebo-controlled trial. J Rheumatol 2009; 36(2): 398–409PubMedCrossRefGoogle Scholar
  97. 97.
    Wood PB. Central role of dopamine in fibromyalgia. Pract Pain Manage 2007; 7(8): 12–8Google Scholar
  98. 98.
    Wood PB. Stress and dopamine: implications for the pathophysiology of chronic widespread pain. Med Hypotheses 2004; 62(3): 420–4PubMedCrossRefGoogle Scholar
  99. 99.
    Holman AJ. Ropinirole, open preliminary observations of a dopamine agonist for refractory fibromyalgia. J Clin Rheumatol 2003; 9(4): 277–9PubMedCrossRefGoogle Scholar
  100. 100.
    GlaxoSmithKline. Fibromyalgia study in adults [ClinicalTrials.gov identifier NCT00256893]. US National Institutes of Health, ClinicalTrials.gov [online]. Available from URL: http://www.clinicaltrials.gov [Accessed 2009 Nov 11]
  101. 101.
    Adler GK, Manfredsdottir VF, Rackow RM. Hypothalamic-pituitary-adrenal axis function in fibromyalgia and chronic fatigue syndrome. Endocrinologist 2002; 12(6): 513–24CrossRefGoogle Scholar
  102. 102.
    Crofford LJ, Young EA, Engleberg NC, et al. Basal circadian and pulsatile ACTH and cortisol secretion in patients with fibromyalgia and/or chronic fatigue syndrome. Brain Behav Immun 2004; 18(4): 314–25PubMedCrossRefGoogle Scholar
  103. 103.
    Wood PB, Patterson JC, Sunderland JJ, et al. Reduced presynaptic dopamine activity in fibromyalgia syndrome demonstrated with positron emission tomography: a pilot study. J Pain 2007; 8(1): 51–8PubMedCrossRefGoogle Scholar
  104. 104.
    Lopez JF, Akil H, Watson SJ. Neural circuits mediating stress. Biol Psychiatry 1999; 46(11): 1461–71PubMedCrossRefGoogle Scholar
  105. 105.
    Wood PB. Fibromyalgia syndrome: a central role for the hippocampus-a theoretical construct. J Musculoskelet Pain 2004; 12(1): 19–26CrossRefGoogle Scholar
  106. 106.
    Kushida CA. Pramipexole for the treatment of restless legs syndrome. Expert Opin Pharmacother 2006; 7(4): 441–51PubMedCrossRefGoogle Scholar
  107. 107.
    Holman AJ, Myers RR. A randomized, double-blind, placebo-controlled trial of pramipexole, a dopamine agonist, in patients with fibromyalgia receiving concomitant medications. Arthritis Rheum 2005; 52(8): 2495–505PubMedCrossRefGoogle Scholar
  108. 108.
    UCB News. UCB announces top-line outcomes for proof-of-concept studies [media release]. 2009 Feb 20 [online]. Available from URL: http://www.search.ucb-group.com/media-room/newsdetail/?det=1292262&select-year=&select-archive=) [Accessed 2009 Nov 1]
  109. 109.
    Coderre TJ, Katz J, Vaccarino AL, et al. Contribution of central neuroplasticity to pathological pain: review of clinical and experimental evidence. Pain 1993; 52(3): 259–85PubMedCrossRefGoogle Scholar
  110. 110.
    Dougherty PM, Palecek J, Paleckova V, et al. The role of NMDA and non-NMDA excitatory amino acid receptors in the excitation of primate spinothalamic tract neurons by mechanical, chemical, thermal, and electrical stimuli. J Neurosci 1992; 12(8): 3025–41PubMedGoogle Scholar
  111. 111.
    Price DD, Mao J, Mayer DJ. Central consequences of persistent pain states. In: Jensen TS, Turner JA, Wiesenfeld-Hallin Z, editors. Proceedings of the 8th World Congress on Pain, Progress in Pain Research and Management. Seattle (WA): I.A.S.P. Press, 1997: 155–84Google Scholar
  112. 112.
    Woolf CJ, Salter MW. Neuronal plasticity: increasing the gain in pain. Science 2000; 288(5472): 1765–9PubMedCrossRefGoogle Scholar
  113. 113.
    Staud R, Vierck CJ, Robinson ME, et al. Effects of the NDMA receptor antagonist dextromethorphan on temporal summation of pain are similar in fibromyalgia patients and normal controls. J Pain 2005; 6(5): 323–32PubMedCrossRefGoogle Scholar
  114. 114.
    MacFarlane JG, Shahal B, Mously C, et al. Periodic K-alpha sleep EEG activity and periodic limb movements during sleep: comparisons of clinical features and sleep parameters. Sleep 1996; 19(3): 200–4PubMedGoogle Scholar
  115. 115.
    Scharf MB, Baumann M, Berkowitz DV. The effects of sodium oxybate on clinical symptoms and sleep patterns in patients with fibromyalgia. J Rheumatol 2003; 30(5): 1070–4PubMedGoogle Scholar
  116. 116.
    Agarwal N, Pacher P, Tegeder I, et al. Cannabinoids mediate analgesia largely via peripheral type 1 cannabinoid receptors in nociceptors. Nat Neurosci 2007; 10(7): 870–9PubMedCrossRefGoogle Scholar
  117. 117.
    Skrabek RQ, Galimova L, Ethans K, et al. Nabilone for the treatment of pain in fibromyalgia. J Pain 2008; 9(2): 164–73PubMedCrossRefGoogle Scholar
  118. 118.
    Schwartz TL, Rayancha S, Rashid A, et al. Modafinil treatment for fatigue associated with fibromyalgia. J Clin Rheumatol 2007; 13(1): 52PubMedCrossRefGoogle Scholar
  119. 119.
    Younger JW, Zautra AJ, Cummins ET. Low-dose naltrexone reduces the primary symptoms of fibromyalgia. PlosOne 2009; 4(4): e5180Google Scholar

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© Adis Data Information BV 2010

Authors and Affiliations

  1. 1.Department of MedicineUniversity of Florida, College of MedicineGainesvilleUSA

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