What are the best treatments for fibromyalgia?

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What are the best treatments for fibromyalgia? | Journal of Family Practice |

July, 2008

Antidepressants, pramipexole (Mirapex and Sifrol), pregabalin (Lyrica), tramadol

(Ultram),

tropisetron (Navoban), and heated pool treatments provide relief for

fibromyalgia pain.

Carville SF, Arendt-Nielsen S, Bliddal H, et al; for EULAR. EULAR evidence-based

recommendations for the management of fibromyalgia syndrome. Ann Rheum Dis.

2008;67:536- 541.

Level of evidence

1a-: Systematic review of randomized trials displaying worrisome heterogeneity

These guidelines were developed by the European League Against Rheumatism

(EULAR), a

multidisciplinary task force of representatives from 11 European countries. To

prepare this

guideline, the group performed a comprehensive search and evaluation of the

available

medical

literature, using a consensus system. Strong evidence was available only for

drug therapy.

Based on a good response in several small trials, the group recommends heated

pool

treatments

with or without exercise (strength of evidence: . Tramadol, antidepressants,

tropisetron,

pramipexole, and pregabalin are effective for reducing pain, and antidepressants

can

improve

function (strength of evidence: A).

Only weak evidence supports the use of tailored exercise programs, cognitive

behavioral

therapy, acetaminophen, or weak opioids. The group recommends against the use of

corticosteroids or

strong opioids.

No research has evaluated the relative benefits of treatment, and most of the

studies have

been short in duration, creating the possibility of a potent placebo effect.

Heated pool treatments, with or without exercise, are effective for

fibromyalgia.