Olanzapine for the Treatment of Fibromyalgia Symptoms

Abstract

Fibromyalgia is a chronic condition that is diagnosed primarily by the presence of generalized pain along with tenderness on palpation of certain body regions. Unfortunately, the pharmacological treatment of fibromyalgia remains problematic. Two patients are described who highlight the use of the atypical neuroleptic olanzapine for the control of symptoms related to fibromyalgia. Prior to the use of olanzapine, both patients had received a multitude of treatments, none of which greatly improved their ability to function in daily activities. With olanzapine, both patients reported a significant decrease in pain and marked improvement in daily functioning. In one case, the pain returned during a period of time when olanzapine was discontinued, an effect that was reversed when olanzapine was reintroduced. The paucity of serious side effects (i.e., extrapyramidal signs) with the atypical neuroleptic olanzapine strongly favors further exploration and use of this drug for the treatment of fibromyalgia symptoms.

Food Intake and Reward Mechanisms in Patients with Schizophrenia: Implications for Metabolic Disturbances and Treatment with Second-Generation Antipsychotic Agents

“…These include clinical presentation of olanzapine overdose, which is indistinguishable from opioid intoxication (O'Malley et al, 1999;Kochhar et al, 2002;Palenzona et al, 2004) and analgesic/antinociceptive properties of clozapine, olanzapine, and rispiridone observed in both human (Kiser et al, 2001;Silberstein et al, 2002;Fe-Bornstein et al, 2002;Khojainova et al, 2002;Gorski and Willis, 2003) and rodent (Schreiber et al, 1997(Schreiber et al, , 1999Weizman et al, 2003) models and ascribed to the opioid mechanisms (Schreiber et al, 1997(Schreiber et al, , 1999Weizman et al, 2003). Taken together, these results suggest that SGAs are likely to have positive impact on the incentive/ motivational reward aspects (including drive to procure food), but at the cost of worsened, or at least not improved opioid-mediated hedonic capacity.…”

A Comparison of Reboxetine and Amitryptilline in the Treatment of Fibromyalgia Syndrome with Co-morbid Depressive Symptoms: An Open-label Preliminary Study

“…A number of pharmacological treatments have been studied with varying degrees of success including anticonvulsants, antispasticity agents, anxiolytics, sedatives, antidepressant, antipsychotics and opioids (7)(8)(9). Antidepressants have an antinociceptive effect on various forms of pain but none of the antidepressant drugs, have yet been approved by the FDA for the treatment of FM (10)(11)(12)(13)(14).…”

Treatment of glossodynia with olanzapine

“…This is the first reported case in the literature of olanzapine successfully relieving the symptoms of glossodynia. Recent case reports demonstrate the potential success of olanzapine in treating patients with other pain disorders: fibromyalgia 14 and cancer pain. 15 The mechanism responsible for this effect of olanzapine is unknown.…”