Selective serotonin reuptake inhibitors for fibromyalgia syndrome

Urrútia, Gerard; Nishishinya, María Betina; Cantrell, Sarah; Haüser, Winfried

doi:10.1590/1516-3180.20151335t1

Cited by 33 publications

(39 citation statements)

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“…There are also no data supporting the use of opioids. The results of randomized controlled trials have demonstrated that tricyclic antidepressants [586,587], anticonvulsants [588], and serotonin norepinephrine reuptake inhibitors (SNRI) [587], but not selective serotonin reuptake inhibitors (SSRI) [589], are able to beneficially affect one or more of the core symptoms of FMS. Pregabalin and the SNRI duloxetine and milnacripran have been approved by the US FDA for the treatment of FMS, though not by the European Medicines Agency.…”

Section: Treatment and Outcome Treatmentmentioning

confidence: 99%

Fibromyalgia: A Critical and Comprehensive Review

Borchers

Gershwin

2015

Clinic Rev Allerg Immunol

215

217

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Fibromyalgia is a disorder that is part of a spectrum of syndromes that lack precise classification. It is often considered as part of the global overview of functional somatic syndromes that are otherwise medically unexplained or part of a somatization disorder. Patients with fibromyalgia share symptoms with other functional somatic problems, including issues of myalgias, arthralgias, fatigue and sleep disturbances. Indeed, there is often diagnostic and classification overlap for the case definitions of a variety of somatization disorders. Fibromyalgia, however, is a critically important syndrome for physicians and scientists to be aware of. Patients should be taken very seriously and provided optimal care. Although inflammatory, infectious, and autoimmune disorders have all been ascribed to be etiological events in the development of fibromyalgia, there is very little data to support such a thesis. Many of these disorders are associated with depression and anxiety and may even be part of what has been sometimes called affected spectrum disorders. There is no evidence that physical trauma, i.e., automobile accidents, is associated with the development or exacerbation of fibromyalgia. Treatment should be placed on education, patient support, physical therapy, nutrition, and exercise, including the use of drugs that are approved for the treatment of fibromyalgia. Treatment should not include opiates and patients should not become poly pharmacies in which the treatment itself can lead to significant morbidities. Patients with fibromyalgia are living and not dying of this disorder and positive outlooks and family support are key elements in the management of patients.

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Section: Treatment and Outcome Treatmentmentioning

confidence: 99%

Fibromyalgia: A Critical and Comprehensive Review

Borchers

Gershwin

2015

Clinic Rev Allerg Immunol

215

217

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“…Chronic widespread pain is frequently associated with other symptoms, such as poor sleep, fatigue, and depression (Wolfe 2013a). People with moderate and severe forms of fibromyalgia often report high disability levels and poor quality of life along with extensive use of medical care (Häuser 2015a; Häuser 2017).…”

Section: Introductionmentioning

confidence: 99%

“…Estimates of prevalence in specific populations vary greatly, but have been reported as being as high as 9% in female textile workers in Turkey and 10% in metalworkers in Brazil (Queiroz 2013). The change in diagnostic criteria does not appear to have significantly affected estimates of prevalence (Wolfe 2013a). …”

Section: Introductionmentioning

confidence: 99%

Serotonin and noradrenaline reuptake inhibitors (SNRIs) for fibromyalgia

Welsch

Üçeyler

Klose

et al. 2018

Cochrane Database of Systematic Reviews

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Background Fibromyalgia is a clinically defined chronic condition of unknown etiology characterized by chronic widespread pain that often co‐exists with sleep disturbances, cognitive dysfunction and fatigue. People with fibromyalgia often report high disability levels and poor quality of life. Drug therapy, for example, with serotonin and noradrenaline reuptake inhibitors (SNRIs), focuses on reducing key symptoms and improving quality of life. This review updates and extends the 2013 version of this systematic review. Objectives To assess the efficacy, tolerability and safety of serotonin and noradrenaline reuptake inhibitors (SNRIs) compared with placebo or other active drug(s) in the treatment of fibromyalgia in adults. Search methods For this update we searched CENTRAL, MEDLINE, Embase, the US National Institutes of Health and the World Health Organization (WHO) International Clinical Trials Registry Platform for published and ongoing trials and examined the reference lists of reviewed articles, to 8 August 2017. Selection criteria We selected randomized, controlled trials of any formulation of SNRIs against placebo or any other active treatment of fibromyalgia in adults. Data collection and analysis Three review authors independently extracted data, examined study quality, and assessed risk of bias. For efficacy, we calculated the number needed to treat for an additional beneficial outcome (NNTB) for pain relief of 50% or greater and of 30% or greater, patient's global impression to be much or very much improved, dropout rates due to lack of efficacy, and the standardized mean differences (SMD) for fatigue, sleep problems, health‐related quality of life, mean pain intensity, depression, anxiety, disability, sexual function, cognitive disturbances and tenderness. For tolerability we calculated number needed to treat for an additional harmful outcome (NNTH) for withdrawals due to adverse events and for nausea, insomnia and somnolence as specific adverse events. For safety we calculated NNTH for serious adverse events. We undertook meta‐analysis using a random‐effects model. We assessed the evidence using GRADE and created a 'Summary of findings' table. Main results We added eight new studies with 1979 participants for a total of 18 included studies with 7903 participants. Seven studies investigated duloxetine and nine studies investigated milnacipran against placebo. One study compared desvenlafaxine with placebo and pregabalin. One study compared duloxetine with L‐carnitine. The majority of studies were at unclear or high risk of bias in three to five domains. The quality of evidence of all comparisons of desvenlafaxine, duloxetine and milnacipran versus placebo in studies with a parallel design was low due to concerns about publication bias and indirectness, and very low for serious adverse events due to concerns about...

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“…Therefore, anti-depressants and mood stabilizers are important in addressing these psychological issues. The black box warning for increased suicidal tendency in young adults with a history of major depressive disorder taking SSRIs should be carefully considered [40]. We recommend that a safety plan be in place in order to monitor for the risk of suicidal ideation and intent and that patients have routine follow-up visits with a psychologist or psychiatrist while prescribed these medications.…”

Section: Pharmacologic Managementmentioning

confidence: 99%

Fibromyalgia: Treating Pain in the Juvenile Patient

Gmuca

Sherry

2017

Pediatr Drugs

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Presently, evidence for the efficacy of medications for the treatment of juvenile fibromyalgia syndrome (JFMS) is limited. While there are medications approved by the US Food and Drug Administration (duloxetine, milnacipran and pregabalin) for adults with fibromyalgia syndrome, there are none for the treatment of JFMS. A variety of medications have been prescribed for the treatment of JFMS, including (but not limited to) non-opioid analgesics, opioids, anticonvulsants, antidepressants, and muscle relaxants. Psychological therapies, most prominently cognitive-behavioral therapy, are the most evidenced-based treatment modalities for JFMS. A multidisciplinary approach, combining pharmacological, behavioral and exercise-based modalities is currently the standard of care for JFMS. In the future, more stringent randomized, controlled trials with longer follow-up periods are needed in order to determine the long-term efficacy and safety of medications in the treatment of JFMS. Additionally, improved recognition of JFMS will allow for better patient recruitment to permit for adequately powered study designs.

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Selective serotonin reuptake inhibitors for fibromyalgia syndrome

Cited by 33 publications

References 1 publication

Fibromyalgia: A Critical and Comprehensive Review

Fibromyalgia: A Critical and Comprehensive Review

Serotonin and noradrenaline reuptake inhibitors (SNRIs) for fibromyalgia

Fibromyalgia: Treating Pain in the Juvenile Patient

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