Fibromyalgia Symptoms And Medications For Treatment | Sasha Gould, PharmD | RxEconsult

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Fibromyalgia Symptoms And Medications For Treatment Category: Rheumatoid Arthritis & Inflammatory Conditions by - July 18, 2015 | Views: 61672 | Likes: 1 | Comment: 0  

Diagnosing Fibromyalgia

A diagnosis of fibromyalgia is based on a patient history of symptoms and physical exam. The physical exam often includes testing tenderness at certain pressure points. The criteria for diagnosing fibromyalgia include:

  • Pain in several areas of the body and other typical fibromyalgia symptoms over the past week
  • Symptoms have been present for at least 3 months at a similar level of severity
  • Symptoms are not caused by other health problems

Laboratory tests are not used for diagnosing fibromyalgia. X-rays and blood tests are often normal or inconclusive and are only used to rule out other causes of the patient’s symptoms.

Medications For Fibromyalgia Treatment

There is no cure for fibromyalgia, however there are medications for managing its symptoms. Knowledge about the disease, what types of activities relieve or increase the pain, as well as a good relationship with healthcare providers are important for managing fibromyalgia.

Treatment starts with complete education about the condition, the different treatment approaches, and the importance of treating other conditions that may be present. Non-drug treatments include good sleep hygiene to help combat fatigue and pain, and a complete exercise regimen that includes aerobic conditioning, stretching and strength training. 

If initial treatment options do not fully provide symptom relief, the next options are using a combination of medications, supervised physical therapy, as well as consultation with other specialists.

If drug therapy is necessary to treat the symptoms of fibromyalgia, the recommended medications are duloxetine, milnacipran, pregabalin, and amitriptyline.

Duloxetine (Cymbalta)

Duloxetine is a serotonin-norepinephrine reuptake inhibitor (SNRI) that is FDA approved to treat fibromyalgia. It increases the levels of serotonin and norepinephrine in the brain. It is useful when patients have depression and fibromyalgia because it is also approved for treating depression.

Milnacipran (Savella)

Milnacipran is a serotonin-norepinephrine reuptake inhibitor (SNRI) approved by the FDA for treating fibromyalgia. It has been shown to be effective when compared to a placebo in various clinical trials. Its exact mechanism of action for reducing fibromyalgia pain is unknown.

Pregabalin (Lyrica)

Pregabalin is a gamma-aminobutyric acid (GABA) analog that is FDA approved to treat fibromyalgia. Pregabalin binds to calcium channels in the brain, however, how it relieves pain is not exactly known. It may block the over-activity of nerve cells that are involved in pain transmission.

Amitriptyline (Elavil)

Amitriptyline is a tricyclic antidepressant that increases the amount of serotonin and norepinephrine. It is not FDA approved to treat fibromyalgia, however it has been shown to be very effective, and is usually recommended before the other treatments. 

Other Medications

Narcotic medications (for example, tramadol), antianxiety medications (for example, alprazolam), muscle relaxants (for example, cyclobenzaprine), anticonvulsants (for example, pregabalin), and clonidine are also used to manage symptoms of fibromyalgia.

Over-the-counter (OTC) pain relievers such as acetaminophen (Tylenol) or NSAIDs (Advil, Aleve) can also provide pain relief for some patients. 


Characteristics and healthcare costs of patients with fibromyalgia syndrome. International Journal of Clinical Practice.


Fibromyalgia : Economic Burden. National Fibromyalgia and Chronic Pain Association.

Fibromyalgia. National Institute of Arthritis and Musculoskeletal and Skin Diseases.


Treatment of Fibromyalgia Syndrome. Evidence-Based Complementary Alternative Medicine


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