Current and Emerging Pharmacotherapy for Fibromyalgia

Abstract

Introduction. Fibromyalgia syndrome (FMS) is a pain disorder with an estimated prevalence of 1–5%. It is associated with a variety of somatic and psychological disorders. Its exact pathogenesis is still unclear but is involved with neural oversensitization and decreased conditioned pain modulation (CPM), combined with cognitive dysfunction, memory impairment, and altered information processing. Connectivity between brain areas involved in pain processing, alertness, and cognition is increased in the syndrome, making its pharmacologic therapy complex. Only three drugs, pregabalin, duloxetine, and milnacipran are currently FDA-approved for FM treatment, but many other agents have been tested over the years, with varying efficacy. Areas Covered. The purpose of this review is to summarize current clinical experience with different pharmacologic treatments used for fibromyalgia and introduce future perspectives in developing therapies. Expert Opinion. Future insights into the fields of cannabinoid and opioid research, as well as an integrative approach towards the incorporation of genetics and functional imaging combined with additional fields of research relevant towards the study of complex CNS disorders, are likely to lead to new developments of novel tailor-made treatments for FMS patients.

Psychoeducation for Patients with Fibromyalgia: A Systematic Review

“…Pharmacological treatment of FM relies mostly on the three drugs that have been approved for this purpose by the FDA (Food and Drug Administration of the United States): pregabalin (a gabapentinoid blocking calcium channels), duloxetine, and milnacipran (both are serotonin-noradrenaline reuptake inhibitors). However, the use of other types of medication, mainly antidepressants (e.g., tricyclic antidepressants, selective serotonin reuptake inhibitors, cyclobenzaprine), is constantly being tested [ 2 , 11 ]. Regardless all efforts, the efficacy of pharmacological treatment is rather modest, often leading to voluntary discontinuation of medication intake as patients with FM perceive little amelioration [ 11 , 12 ].…”

Brief Acceptance and Commitment Therapy for Fibromyalgia: Feasibility and Effectiveness of a Replicated Single-Case Design

“…There is now quality evidence supporting the utility of several pharmacological (i.e., antidepressants and antiseizure drugs) and nonpharmacological treatment (i.e., Cognitive Behavioral Therapy, CBT) options for FM [ 6 , 7 ]. Indeed, CBT has become a frequent treatment for FM patients, and systematic reviews and meta-analyses so far indicate that moderate effects on physical disability and mental distress are obtained with CBT, while pain intensity changes tend to be smaller [ 8 , 9 ].…”

Update Fibromyalgiesyndrom

“…sexueller) und emotionale Missbrauchserfahrungen und ungelöste emotionale Konflikte nachweisen. Im Sinne einer Differenzialindikation psychotherapeutischer Verfahren ist eine methodisch hochwertige RCT mit Emotional Awareness and Expression Therapy (EAET) von Interesse, die eine Überlegenheit in der Reduktion von FMS-Symptomen im Vergleich zu einer Wartegruppe, aber für einige Variablen auch zu einer "fairen" Kontrollgruppe (kognitive Verhaltenstherapie) zeigte [48]. Ein deutschsprachiges Manual der EAET liegt vor (Beutel, persönliche Mitteilung).…”