Fibromyalgia Treatment Options

Fibromyalgia Treatment Options

As with many other medically unexplained syndromes, there is no generally accepted treatment or cure for fibromyalgia, treatment usually consists of symptom management. The developments in the understanding of the pathophysiology of the disease have to run improvements in treatment, taking prescription medication, behavior therapy, exercise and alternative and complementary medicine covers. In fact integrate integrated treatment plans, medication, patient education, aerobic and cognitive behavior therapy have been shown effective in alleviating pain and other fibromyalgia symptoms. In the year 2005, the American Pain Society guidelines for comprehensive patient evaluation and management.Recently, the European League Against Rheumatism (EULAR) has updated treatment guidelines.

Check some Fibromyalgia Treatment Options:

Psychological / behavioral therapies
Cognitive behavioral therapy (CBT) and related mental / behavioral therapies are evidence-based treatments, which are shown to be only partially effective in randomized controlled studies. The greatest benefit occurs when CBT is used along with exercise.

Pharmaceutical
There are three drugs that were approved by the FDA for the treatment of fibromyalgia approved. Pregabalin was approved in June 2007, was approved in June 2008, duloxetine and milnacipran was approved in January 2009. Pregabalin and duloxetine have shown that reducing pain in a significant number of patients with fibromyalgia, but there were others who had not benefited. Placebo-controlled trials involving more than 2000 patients have shown milnacipran significantly more effective than placebo in the treatment of pain and the broader syndrome of fibromyalgia.

Antidepressants
A 2009 meta-analysis in the Journal of the American Medical Association found that antidepressants “associated with improvements in pain, depression, fatigue, insomnia and health-related quality of life in patients with FMS.” The authors have also noted that should the target of antidepressants in fibromyalgia “possible symptom reduction,” and when used long term, their effects are studied side effects. Tricyclic antidepressants were the most effective against pain, fatigue and insomnia, but too many side effects due to interaction with adrenergic, cholinergic or histaminergic receptors and sodium channels. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) had fewer side effects.

Tramadol
Tramadol, a centrally acting analgesic with opioid and atypical antidepressant-like activity is moderately effective in treating fibromyalgia pain. Long-term efficacy and safety are not known. Tramadol combined with acetaminophen rapid, lasting relief, the more effective than either drug alone. This combination therapy is the efficacy, safety and tolerability for up to two years without the development of tolerance shown in the treatment of chronic pain. It is as effective as codeine and paracetamol, but produces less drowsiness and constipation, and it is free from the toxic effects associated with non-steroidal anti-inflammatory.

Anti-seizure drugs
The anti-seizure medication gabapentin (Neurontin) and pregabalin (Lyrica) were tested. Gabapentin is approved for use in the treatment of neuropathic pain but not fibromyalgia. Pregabalin, originally suffered in the treatment of nerve pain in diabetics known, has been cleared by the U.S. Food and Drug Administration to treat fibromyalgia. A randomized controlled trial of pregabalin 450 mg / day found that 6 patients will have the number needed to treat for one patient, a 50% reduction in pain. A Cochrane Database analysis of pregabalin in chronic pain concluded that “a minority of patients have significant advantages with pregabalin, and will benefit more moderate. Many have no or trivial benefit, or they will break due to side effects. “A meta-analysis identified four studies of pregabalin in fibromyalgia that for patients, the response to pregabalin, there was a decline in the period of work> 1 day per week.

Dopamine agonists
Dopamine agonists (eg pramipexole (Mirapex) and ropinirole (Requip)) led to some improvement in a minority of patients, but numerous side effects, including the occurrence of impulse control disorders like pathological gambling and shopping centers its concerns have led on this approach. A trial of transdermal rotigotine is currently under way.

Muscle relaxants
Cyclobenzaprine is a muscle relaxant drug to skeletal muscle spasms and pain associated with acute musculoskeletal disorders to relieve. It is the most extensively studied drug for this use, and it was also off-label for fibromyalgia treatment used.
Tizanidine (Zanaflex brand names, Sirdalud) is a centrally acting muscle ?-2-adrenergic agonists. It is used to treat the spasms, cramping, and tightness of muscles caused by medical problems such as multiple sclerosis, spastic diplegia, back pain, or certain other injuries to the spine or central nervous system caused. There is also off-label for some of the symptoms of fibromyalgia.

Soon I will write more about Fibromyalgia Treatment Options.