Pharmacological Treatment Of Fibromyalgia Research Articles

Pharmacological treatment of fibromyalgia

Pharmacological treatment of fibromyalgia

The current treatment of fibromyalgia

ABSTRACT BACKGROUND AND OBJECTIVES: Fibromyalgia is a highly relevant theme for research considering its impressive 2% worldwide prevalence, diffuse pain and suffering, largely unknown pathophysiology, scarce odds of cure and, more often than not, poor symptom control. This study aims to review the main options of treatment for fibromyalgia, including some novel alternatives. CONTENTS: The pharmacological treatment for fibromyalgia can be prescribed in monotherapy or combination of drugs, which comprises antidepressants, muscle relaxants, anticonvulsants, cannabinoids, opioids, N-methyl D-Aspartate antagonists, melatoninergic agonists, peptidergic substances among others. Non-pharmacological therapies include acupuncture, behavioral (or psychobehavioral) and psychological (or psychotherapy) interventions, physical activity programs, hyperbaric oxygen therapy, ozone therapy, transcranial magnetic stimulation, stretching exercises associated to low intravenous curare doses, among others. Treatment modalities are presented according to possible mechanisms of action, level of scientific evidence and recommendation. CONCLUSION: Fibromyalgia therapy should be individualized, and it does not aim the cure. Its objective is to reduce the subject’s suffering; provide function improvement and, as much as possible, the individual’s autonomy and quality of life. There is much in common in most approach recommendations, yet there are some divergence and changes as knowledge is acquired about a theme where consensus is far from being achieved.

Anti-hyperalgesic effect of Lippia grata leaf essential oil complexed with β-cyclodextrin in a chronic musculoskeletal pain animal model: Complemented with a molecular docking and antioxidant screening

BackgroundDue to its unclear pathophysiology, the pharmacological treatment of fibromyalgia is a challenge for researchers. Studies using medicinal plants, such as those from the genus Lippia, complexed with cyclodextrins (CDs) have shown innovative results. ObjectiveThe present research intended to evaluate the effect of an inclusion complex containing β-cyclodextrin (βCD) inclusion complex with Lippia grata (LG) essential oil in a chronic musculoskeletal pain model, its central activity and its possible interaction with neurotransmitters involved in pain. MethodsAfter acid saline-induced chronic muscle pain, male mice were evaluated for primary and secondary hyperalgesia and muscle strength. Moreover, an antagonist assay was performed to assess the possible involvement of the opioidergic, serotonergic and noradrenergic pathways. In addition, Fos protein in the spinal cord was assessed, and a docking study and antioxidant assays were performed. ResultsThe treatment with LG-βCD, especially in the dose of 24mg/kg, was able to significantly decrease (p<0.05) the paw withdrawal and muscle threshold. Furthermore, LG-βCD was shown to affect the opioidergic and serotonergic pathways. There were no significant changes in muscle strength. Fos protein immunofluorescence showed a significant decrease in expression in the dorsal horn of the spinal cord. The main compounds of LG showed through the docking study interaction energies with the alpha-adrenergic and μOpioid receptors. In all antioxidant assays, LG exhibited stronger antioxidant activities than LG-βCD. ConclusionThis study suggested that LG-βCD could be considered as a valuable source for designing new drugs in the treatment of chronic pain, especially musculoskeletal pain.

Pharmacological treatment of fibromyalgia: is the glass half empty or half full?

Pharmacological treatment of fibromyalgia: is the glass half empty or half full?

Pharmacological treatment of fibromyalgia

Pharmacological treatment of fibromyalgia

Current status of atypical antipsychotics for fibromyalgia

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 antipsychotics are poorly tolerated in patients with fibromyalgia, and only quetiapine XR has been studied in randomized controlled trials. Quetiapine XR has demonstrated effectiveness in treating comorbid major depression, anxiety and sleep disturbance. However, in two randomized controlled trials, quetiapine XR was not differentiated from placebo and failed to demonstrate noninferiority to amitriptyline in terms of improving overall symptomatology. The effect of quetiapine XR on pain and its usefulness as part of a combination pharmacological regimen should be further evaluated. Overall, the use of quetiapine (initiated at a low dose and slowly titrated) in fibromyalgia should be limited to patients with comorbid major depression or patients who are currently receiving other treatments and have unresolved and disabling depressive and/or anxiety symptoms.

Efficacy of Cognitive Behaviour Therapy in Fibromyalgia as compared with Myofascial Release Technique

BACKGROUND: Fibromyalgia (FM) is a nonspecific rheumatologic disorder, characterized by widespread pain present for 3 months or more and acute response to digital palpation in at least 11 of 18 tender points resulting in stiffness, fatigue, depression, anxiety and sleep disturbances affecting 2% of the population with a female-to-male ratio of approximately 9:1.The conventional treatment such as LASER, Biofeedback, Transcutaneous Electrical Muscle Stimulator (TENS), Thermotherapy and Ultrasound along with Myofascial Release techniques (MFR) are helpful in reducing the symptoms of FM. The programs of physical training, relaxation techniques, self-assertion, anxiety management, emotional awareness courses and education programs are being associated with pharmacological treatment for FM that help patients in understanding the illness and learn to live with it. A multidisciplinary healthcare approach is required to address the multidimensional nature of FMS. METHOD: 22 patients consisting of 3 males and 19 females were selected for the randomized control trial and were divided into two groups by using simple randomization method. Group A (N=11) received MFR technique along with conventional physiotherapy (hot fomentation, ultrasound and TENS) and group B (N=11) received Cognitive Behaviour Therapy (CBT) in adjunct to MFR technique and conventional physiotherapy. Primary outcome measure Fibromyalgia Impact Questionnaire (FIQR) and Secondary outcome measure Depression Anxiety and Stress Questionnaire (DASS), Epworth Sleepiness Scale (ESS), Visual Analogue Scale (VAS) and Functional Independence Measure (FIM) were recorded on 1st, 15th and 30th day. RESULTS: Results of the present study indicate that statistically there is no difference in the efficacy of CBT along with MFR and conventional therapy and the MFR along with conventional therapy for the treatment of FM symptoms of pain, depression, anxiety, stress, sleepiness and hampered quality of life. However, both the treatments have shown good prognosis. The Researcher found that the patients under group B who were administered CBT has shown significant effects in reducing FM symptoms and maintaining them for longer duration of time as compared with the patients under group. Hence, it is reliable method for reducing the features of FMS. KEY WORDS: Fibromyalgia, Cognitive Behaviour Therapy, Myofascial Release, Conventional therapy.

Pharmacological treatment of fibromyalgia

Fibromyalgia syndrome (FM) is a condition of chronic and diffuse muscular pain affecting particularly middle aged women. The aetiology of FM is not completely understood and it is currently considered a disorder of pain regulation. The most efficacious compounds include the tricyclic drugs and mixed reuptake inhibitors. Recent works suggest that the anticonvulsant medications pregabalin and gabapentin are also effective. Moreover, two serotonin and norepinephrine-reuptake inhibitors-duloxetine and milnacipran show encouraging results in treating FM symptoms. The results of clinical trials of anti-inflammatory medications have been generally disappointing, but three RCTs have found that tramadol (with or without acetaminophen) is effective in FM.

Pharmacological Treatment of Fibromyalgia

Fibromyalgia is a chronic disease characterized by chronic widespread musculoskeletal pain with multiple tender points. It is associated with multiple debilitating symptoms, such as fatigue and sleep problems, and is often accompanied by depressed mood. It is one of the most common rheumatic syndromes encountered in primary care, affecting approximately 5% of the general population, predominantly women. The cause is unknown, but it has become recognized as a real, not imaginary, medical condition.

Pharmacological treatment of fibromyalgia and other chronic musculoskeletal pain

The pharmacologic management of fibromyalgia is based on the emerging evidence that pain in this disorder is primarily related to central pain sensitization. There is strong evidence that tricyclic antidepressants are effective, and moderate evidence for the effectiveness of serotonin reuptake inhibitors and dual serotonin-norepinephrine reuptake inhibitors. Recent work suggests that the anti-seizure medications pregabalin and gabepentin are also effective. The only analgesic demonstrated to be helpful is tramadol.

Pharmacologic treatment of fibromyalgia

Fibromyalgia is a syndrome of widespread pain, nonrestorative sleep, disturbed mood, and fatigue. Optimal treatment involves a multidisciplinary approach with a team of health care providers using pharmacologic and nonpharmacologic treatment. Because of the heterogeneity of the illness, management should be individualized for the patient. Pharmacologic treatment should address issues of pain control, sleep disturbance, fatigue, and any underlying coexisting mood disorder. Nonpharmacologic treatment should include patient education, a regular exercise and stretching program, and cognitive behavioral therapy. All of these are essential to improving functional capacity and quality of life. This review provides general guidelines in initiating a successful pharmacologic treatment program for patients with fibromyalgia.

Pharmacologic treatment of fibromyalgia

Fibromyalgia is a syndrome of widespread pain, nonrestorative sleep, disturbed mood, and fatigue. Optimal treatment involves a multidisciplinary approach with a team of health care providers using pharmacologic and nonpharmacologic treatment. Because of the heterogeneity of the illness, management should be individualized for the patient. Pharmacologic treatment should address issues of pain control, sleep disturbance, fatigue, and any underlying coexisting mood disorder. Nonpharmacologic treatment should include patient education, a regular exercise and stretching program, and cognitive behavioral therapy. All of these are essential to improving functional capacity and quality of life. This review provides general guidelines in initiating a successful pharmacologic treatment program for patients with fibromyalgia.

The Role of Serotonin Norepinephrine Reuptake Inhibitors in the Treatment of Fibromyalgia: A Guide for the Physician Assistant

Fibromyalgia is a controversial polysymptomatic syndrome of unknown etiology. Diagnosis of fibromyalgia is often problematic due to numerous concomitant conditions that mimic this disorder. Additionally, the validity of fibromyalgia as a true physiologic condition remains a point of debate within the scientific community. Fibromyalgia reportedly occurs in approximately two percent of the United States population and clinical presentation typically occurs in the primary care setting. Fibromyalgia is more common than rheumatoid arthritis and poses a significant health issue because no curative treatment exists. This disorder can lead to significant patient disability and economic burden especially if diagnosis is delayed. There are many pharmacological treatments for fibromyalgia, however there is no drug of choice. As more patients are being seen in the primary care setting and are presenting with fibromyalgia, it is imperative that physician assistants remain up-to-date regarding pharmacological treatments and underlying mechanisms of action. The purpose of the paper is to describe results from various investigations on the efficacy and effectiveness of serotonin norepinephrine reuptake inhibitors in treating patients with fibromyalgia in the ambulatory primary care setting. This paper is a review article that will discuss serotonin norepinephrine reuptake inhibitors currently on the market and compare them to other pharmacological treatments used in fibromyalgia.

Pharmacologic treatment of fibromyalgia.

Fibromyalgia is a chronic syndrome characterized by widespread pain, unrefreshed sleep, disturbed mood, and fatigue. Until such time as we have a clearer understanding of the trigger and/or pathophysiologic mechanisms producing these symptoms, pharmacologic treatment should be aimed at individual symptoms. Such treatment should ideally be offered as part of a multidisciplinary treatment program using both pharmacologic and nonpharmacologic treatment modalities. Critical components of any successful fibromyalgia treatment program include addressing physical fitness, work and other functional activities, and mental health, in addition to symptom-specific therapies. The main symptoms that should be addressed include pain, sleep disturbances including restless leg syndrome, mood disturbances, and fatigue. Pharmacologic therapy should also be considered for syndromes commonly associated with fibromyalgia including irritable bowel syndrome, interstitial cystitis, migraine headaches, temporomandibular joint dysfunction, dysequilibrium including neurally mediated hypotension, sicca syndrome, and growth hormone deficiency. This article provides general guidelines in initiating a successful pharmacologic treatment program for fibromyalgia.