Armodafinil for Fibromyalgia Fatigue

Schwartz, Thomas L.; Siddiqui, Umar A.; Raza, Shafi; Morell, Martin

doi:10.1345/aph.1m736

Cited by 14 publications

(16 citation statements)

References 7 publications

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“…Central nervous system stimulants may be most appropriate for patients with fatigue and comorbid narcolepsy. Though this class of medications is widely adopted in clinical practices to help patients with function, there are not enough data to support this practice [52,123,152]. Despite the demonstrated efficacy of some of these pharmacological agents, the clinician should be mindful that not all patients with fibromyalgia can tolerate medications.…”

Section: Fatigue Managementmentioning

confidence: 99%

Beyond pain in fibromyalgia: insights into the symptom of fatigue

et al. 2013

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Fatigue is a disabling, multifaceted symptom that is highly prevalent and stubbornly persistent. Although fatigue is a frequent complaint among patients with fibromyalgia, it has not received the same attention as pain. Reasons for this include lack of standardized nomenclature to communicate about fatigue, lack of evidence-based guidelines for fatigue assessment, and a deficiency in effective treatment strategies. Fatigue does not occur in isolation; rather, it is present concurrently in varying severity with other fibromyalgia symptoms such as chronic widespread pain, unrefreshing sleep, anxiety, depression, cognitive difficulties, and so on. Survey-based and preliminary mechanistic studies indicate that multiple symptoms feed into fatigue and it may be associated with a variety of physiological mechanisms. Therefore, fatigue assessment in clinical and research settings must consider this multi-dimensionality. While no clinical trial to date has specifically targeted fatigue, randomized controlled trials, systematic reviews, and meta-analyses indicate that treatment modalities studied in the context of other fibromyalgia symptoms could also improve fatigue. The Outcome Measures in Rheumatology (OMERACT) Fibromyalgia Working Group and the Patient Reported Outcomes Measurement Information System (PROMIS) have been instrumental in propelling the study of fatigue in fibromyalgia to the forefront. The ongoing efforts by PROMIS to develop a brief fibromyalgia-specific fatigue measure for use in clinical and research settings will help define fatigue, allow for better assessment, and advance our understanding of fatigue.

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Section: Fatigue Managementmentioning

confidence: 99%

Beyond pain in fibromyalgia: insights into the symptom of fatigue

et al. 2013

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“…In the regions of the brain where fatigue is believed to be interpreted modifinil and armodafinil are proposed to elevate histamine, noradrenaline, serotonin, glutamine and dopamine activity [54], thus treatment may allow the brain to interpret a lower fatigue state in patients with FM. In retrospective studies, fatigue associated with FM was reported to be reduced by modafinil [55].…”

Section: Bioamine Neurotransmittersmentioning

confidence: 99%

“…However, armodafinil (50-250mg/d), in a proof-of-concept blinded, randomized placebo-controlled study, however failed to treat the fatigue associated with FM; however, a large placebo effect (up to 46%) was observed in the patient population making interpretation of the outcomes unreliable [55]. Methylphenidate (Ritalin; 10-60mg/day), a neuronal stimulate that inhibits dopamine and noradrenaline reuptake, has been observed to enhance mood and concentration in patients with FM after 30-day treatment, although other symptoms such as pain intensity failed to improve [56].…”

Section: Bioamine Neurotransmittersmentioning

confidence: 99%

Potential drug therapies for the treatment of fibromyalgia

Lawson

2016

Expert Opinion on Investigational Drugs

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Modest improvement of health status in patients with FM has been observed with drugs targeting a diverse range of molecular mechanisms. No single drug, however, offered substantial efficacy against all the symptoms characteristic of FM. Identification of new and improved therapies for FM needs to address the heterogeneity of the condition, which suggests existence of patient subgroups, the relationship of central and peripheral aspects of the pathophysiology and a requirement of combination therapy with drugs targeting multiple molecular mechanisms.

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“…Armodafi nil was also effective in reducing sleepiness due to jet lag following eastward travel through 6 time zones [ 145 ] . The drug has been effective in the setting of fatigue related to fi bromyalgia [ 146 ] . 42 …”

Section: Armodafi Nilmentioning

confidence: 99%

Pharmacology of Sleep

Chowdhuri

2011

Essentials of Sleep Medicine

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Armodafinil for Fibromyalgia Fatigue

Cited by 14 publications

References 7 publications

Beyond pain in fibromyalgia: insights into the symptom of fatigue

Beyond pain in fibromyalgia: insights into the symptom of fatigue

Potential drug therapies for the treatment of fibromyalgia

Pharmacology of Sleep

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