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Drug therapy of fibromyalgia syndrome : Updated guidelines 2017 and overview of systematic review articles.
CONCLUSION: Amitriptyline and duloxetine are recommended in the case of comorbid depressive disorders or generalized anxiety disorder and pregabalin in the case of generalized anxiety disorder. Off-label use of duloxetine and pregabalin can be considered if there are no comorbid mental disorders or no generalized anxiety disorder. Strong opioids are not recommended. PMID: 28493231 [PubMed - as supplied by publisher]
Source: Schmerz - May 10, 2017 Category: Anesthesiology Authors: Sommer C, Alten R, Bär KJ, Bernateck M, Brückle W, Friedel E, Henningsen P, Petzke F, Tölle T, Üçeyler N, Winkelmann A, Häuser W Tags: Schmerz Source Type: research

Management of fibromyalgia: practical guides from recent evidence-based guidelines.
Authors: Häuser W, Ablin J, Perrot S, Fitzcharles MA Abstract Fibromyalgia (FM) is a prevalent and costly condition worldwide, affecting approximately 2% of the general population. Recent evidence- and consensus-based guidelines from Canada, Germany, Israel and the European League Against Rheumatism aim to support physicians in achieving a comprehensive diagnostic work-up of patients with chronic widespread pain (CWP) and to assist patients and physicians in shared decision making on treament options. Every patient with CWP requires at the first medical evaluation a complete history, medical examination and some l...
Source: Polskie Archiwum Medycyny Wewnetrznej - January 12, 2017 Category: Internal Medicine Tags: Pol Arch Med Wewn Source Type: research

Cannabinoids for fibromyalgia.
CONCLUSIONS: We found no convincing, unbiased, high quality evidence suggesting that nabilone is of value in treating people with fibromyalgia. The tolerability of nabilone was low in people with fibromyalgia. PMID: 27428009 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - July 17, 2016 Category: Journals (General) Authors: Walitt B, Klose P, Fitzcharles MA, Phillips T, Häuser W Tags: Cochrane Database Syst Rev Source Type: research

Effect of intravenous lidocaine combined with amitriptyline on pain intensity, clinical manifestations and the concentrations of IL‐1, IL‐6 and IL‐8 in patients with fibromyalgia: A randomized double‐blind study
ConclusionsThe combination of 240 mg of intravenous lidocaine (once a week for 4 weeks) with 25 mg of amitriptyline for 8 weeks had no meaningful impact in fibromyalgia patients.
Source: APLAR Journal of Rheumatology - June 15, 2016 Category: Rheumatology Authors: Ana Laura Albertoni Giraldes, Reinaldo Salomão, Plinio da Cunha Leal, Milena Karina Coló Brunialti, Rioko Kimiko Sakata Tags: Original Article Source Type: research

Antipsychotics for fibromyalgia in adults.
CONCLUSIONS: Very low quality evidence suggests that quetiapine may be considered for a time-limited trial (4 to 12 weeks) to reduce pain, sleep problems, depression and anxiety in fibromyalgia patients with major depression. Potential side effects such as weight gain should be balanced against the potential benefits in shared decision making with the patient. PMID: 27251337 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - June 1, 2016 Category: Journals (General) Authors: Walitt B, Klose P, Üçeyler N, Phillips T, Häuser W Tags: Cochrane Database Syst Rev Source Type: research

Treatment Initiation Timing and Healthcare Costs in Newly Diagnosed Patients with Fibromyalgia (P6.276)
Conclusions:Total healthcare costs were significantly lower among early initiation patients, suggesting early use as a potential cost-saving strategy. FM patients had substantial comorbidity and most did not receive ACR recommended medications. Study Supported by: Daiichi Sankyo, Inc.Disclosure: Dr. Frech-Tamas has nothing to disclose. Dr. Qian has nothing to disclose. Dr. Gore has nothing to disclose. Dr. Zhang has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Frech, F., Qian, C., Gore, M., Zhang, Q. Tags: Pain and Palliative Care Source Type: research

“Clinical Approach to Fibromyalgia: Synthesis of Evidence-based Recommendations, a Systematic Review”
Conclusions Final recommendations in this review identify optimal treatments, facilitating the translation of evidence into practice and enabling more efficient and effective quality care.
Source: Reumatologia Clinica - March 3, 2016 Category: Rheumatology Source Type: research

Comparative Efficacy of Newer Antidepressants in Combination with Pregabalin for Fibromyalgia Syndrome: A Controlled, Randomized Study
ConclusionThe combined use of pregabalin plus paroxetine offers an effective method with increased tolerability to reduce the somatic and depressive symptoms of fibromyalgia and to enhance the quality of life in affected individuals.
Source: Pain Practice - February 19, 2016 Category: Anesthesiology Authors: Eiad A. Ramzy Tags: Original Article Source Type: research

Efficacy, tolerability and safety of cannabinoids in chronic pain associated with rheumatic diseases (fibromyalgia syndrome, back pain, osteoarthritis, rheumatoid arthritis) : A systematic review of randomized controlled trials.
CONCLUSIONS: Currently, there is insufficient evidence for recommendation for any cannabinoid preparations for symptom management in patients with chronic pain associated with rheumatic diseases. PMID: 26767993 [PubMed - as supplied by publisher]
Source: Schmerz - January 14, 2016 Category: Anesthesiology Authors: Fitzcharles MA, Baerwald C, Ablin J, Häuser W Tags: Schmerz Source Type: research

Melatonin analgesia is associated with improvement of the descending endogenous pain-modulating system in fibromyalgia: a phase II, randomized, double-dummy, controlled trial.
CONCLUSION: Melatonin increased the inhibitory endogenous pain-modulating system as assessed by the reduction on NPS(0-10) during the CPM-TASK. Melatonin alone or associated with amitriptyline was better than amitriptyline alone in improving pain on the VAS, whereas its association with amitriptyline produced only marginal additional clinical effects on FIQ and PPT. TRIAL REGISTRATION: Current controlled trail is registered at clinical trials.gov upon under number NCT02041455. Registered January 16, 2014. PMID: 25052847 [PubMed - indexed for MEDLINE]
Source: BMC Pharmacology and Toxicology - November 20, 2015 Category: Drugs & Pharmacology Tags: BMC Pharmacol Toxicol Source Type: research

Fibromyalgia · anxiety/depression · urinary retention · Dx?
Abstract A 72-year-old woman came to our internal medicine department clinic for a follow-up appointment for her fibromyalgia. Thirteen months earlier, she had sought care at our facility not only for fibromyalgia, but for insomnia, anxiety, depression, and urinary incontinence. At the time, we prescribed amitriptyline 10 mg/d--for her pain and depression--as well as clonazepam 10 mg/d and paracetamol 650 mg, as needed. PMID: 26546961 [PubMed - in process]
Source: The Journal of Family Practice - September 1, 2015 Category: Practice Management Authors: Roth-Damas P, Sempere-Manuel M, Palop-Larrea V Tags: J Fam Pract Source Type: research

Amitriptyline for fibromyalgia in adults.
CONCLUSIONS: Amitriptyline has been a first-line treatment for fibromyalgia for many years. The fact that there is no supportive unbiased evidence for a beneficial effect is disappointing, but has to be balanced against years of successful treatment in many patients with fibromyalgia. There is no good evidence of a lack of effect; rather our concern should be of overestimation of treatment effect. Amitriptyline will be one option in the treatment of fibromyalgia, while recognising that only a minority of patients will achieve satisfactory pain relief.It is unlikely that any large randomised trials of amitriptyline will be ...
Source: Cochrane Database of Systematic Reviews - August 3, 2015 Category: Journals (General) Authors: Moore RA, Derry S, Aldington D, Cole P, Wiffen PJ Tags: Cochrane Database Syst Rev Source Type: research

Oral Burning With Dysphagia and Weight Loss
We report on the case of a patient with fibromyalgia, who presented with dysphagia, odynophagia, and glossodynia as prevalent symptoms. Difficulty in swallowing gradually developed over a month prior hospitalization, and worsened progressively so that nourishment and fluid intake were impeded. Because anemia with mild iron deficiency was found, esophagogastroduodenoscopy was performed, but no lesions were seen in the upper digestive tract. Levels of zinc and vitamin B12 were normal. Intense pain at pelvis and the inferior limbs, which was at a first glance referred to as osteoarthrosis, associated with oral symptoms and fe...
Source: Medicine - August 1, 2015 Category: Internal Medicine Tags: Research Article: CLINICAL CASE REPORT Source Type: research

Amitriptyline for neuropathic pain in adults.
CONCLUSIONS: Amitriptyline has been a first-line treatment for neuropathic pain for many years. The fact that there is no supportive unbiased evidence for a beneficial effect is disappointing, but has to be balanced against decades of successful treatment in many people with neuropathic pain. There is no good evidence of a lack of effect; rather our concern should be of overestimation of treatment effect. Amitriptyline should continue to be used as part of the treatment of neuropathic pain, but only a minority of people will achieve satisfactory pain relief. Limited information suggests that failure with one antidepressant...
Source: Cochrane Database of Systematic Reviews - July 6, 2015 Category: Journals (General) Authors: Moore RA, Derry S, Aldington D, Cole P, Wiffen PJ Tags: Cochrane Database Syst Rev Source Type: research

Current status of atypical antipsychotics for the treatment of fibromyalgia.
Authors: Rico-Villademoros F, Calandre EP, Slim M Abstract The treatment of fibromyalgia requires pharmacological and nonpharmacological therapies. The pharmacological treatment of fibromyalgia is limited to a few drugs that have been demonstrated to be moderately effective in some but not all dimensions of the disease. Therefore, the search for new drugs to treat this condition is warranted. Atypical antipsychotics offered an attractive alternative because they had been shown to be active against several key symptoms of fibromyalgia. The results of open-label studies, however, appear to indicate that atypical anti...
Source: Drugs of Today - June 4, 2015 Category: Drugs & Pharmacology Tags: Drugs Today (Barc) Source Type: research

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