Fibromyalgia syndrome (FMS) affects 2-10% of the adult population in industrial countries and although it is associated with substantial morbidity and disability, treatment options are unsatisfactory. The rapid growth of trials for FMS in recent years has resulted in new, evidence-based approaches to medical treatment. This review focuses on the randomized, controlled studies of newer pharmacological options for FMS, such as selective serotonin/norepinephrine reuptake inhibitors (duloxetine, milnacipran), inhibitors of voltage-gated calcium channels (pregabalin, gabapentin), dopamine-2/3-receptor agonists (pramipexole, ropirinole), sedative-hypnotic agents (sodium oxybate, modafinil, dronabinol), 5-HT3 antagonists (tropisetron) and others (tramadol, dextromethorphan, olanzapine).