Pharmacotherapy for fibromyalgia has become more prevalent in clinical practice as our understanding of the cellular, molecular and pathophysiologic mechanisms contributing to widespread musculoskeletal and neuropathic pain has evolved. Thus, several pain pathways including high-voltage activated Ca2+ channels and the Kv1 family of K+ ion channels appear related to the efficacy of pregabalin and amitriptyline, respectively. Serotonin and norepinephrine reuptake inhibitors - including mirtazapine, duloxetine and milnacipran - appear to be more efficacious in FMS than selective serotonin reuptake inhibitors.
Clin Exp Rheumatol. 2009 Sep-Oct;27(5 Suppl 56):S86-91.
Fibromyalgia Pain Reduced by Low-Dose Naltrexone
Pain Med. 2012;13(2):Abstract 251.
LDN reduced fibromyalgia symptoms in ten women meeting criteria for fibromyalgia, with a greater than 30% reduction of symptoms over placebo. In addition, laboratory visits showed that mechanical and heat pain thresholds were improved by the drug while side effects were rare, and described as minor and transient.
Pain Med. 2009 May-Jun;10(4):663-72. Epub 2009 Apr 22.
J Pain. 2006 Jun;7(6):391-8.
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