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Fibromyalgia Syndrome: Approach to Management

Published online by Cambridge University Press:  07 November 2014

I. Jon Russell
I. Jon Russell*
Affiliation:
Dr. Russell is associate professor of medicine and director of the University Clinical Research Center at the, University of Texas Health Sciences Center in San Antonio
*
Department of Medicine, Mail Code 7868, University of Texas Health Center, 7703 Floyd Curl Dr, San Antonio, TX 78229-3900; Tel: 201-567-4661; E-mail: russell@uthscsa.dcci.com
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Abstract

The management of fibromyalgia syndrome (FMS) has traditionally been multimodal and multidisciplinary, including education, physical modalities, and medication. In this article, an acronym is offered to help the clinician remember the important components of management. An improved understanding of the pathogenesis of FMS has allowed substantial refinements in its treatment. This is particularly true for medications that target specific symptom domains, allowing individualization of therapy. Since all FMS patients experience pain, there has been emphasis on that domain although medications are now available to address two or more domains with monotherapy. In addition, a logical basis is provided to help the clinician design strategic polypharmacy.

Information

Type
Research Article
Information
CNS Spectrums , Volume 13 , Issue S5 , March 2008, pp. 27 - 33
Copyright
Copyright © Cambridge University Press 2008

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References

REFERENCES

1.Russell, IJ, Bieber, C. Muscle and fibromyalgia Ssyndrome. In: SB, McMahon, Koltzenburg, M, ed. Wall and Melzack's Textbook of Pain. London, England: Elsevier: 2005.Google Scholar
2.Russell, IJ. Fibromyalgia syndrome: approaches to management. Bull Rheum Dis. 1996;45(3):1–4.Google Scholar
3.Burckhardt, CS. Nonpharmacologic management strategies in fibromyalgia. Rheum Dis Clin North Am. 2002;28(2):291–304.Google Scholar
4.Jones, KD, Clark, SR. Individualizing the exercise prescription for persons with fibro-myalgia. Rheum Dis Clin North Am. 2002;28(2):419–436.Google Scholar
5.Jones, KD, Clark, SR, Bennett, RM. Prescribing exercise for people with fibromyalgia. AACN Clin Issues. 2002;13(2):277–293.Google Scholar
6.Paiva, ES, Deodhar, A, Jones, KD, Bennett, R. Impaired growth hormone secretion in fibromyalgia patients: evidence for augmented hypothalamic somatostatin tone. Arthritis Rheum. 2002;46(5):1344–1350.Google Scholar
7.Meyer, HP, Van der Westhuizen, FD. Impact of spinal surgery in patients with fibro-myalgia syndrome and back pain. J Musculoske Pain. 2004;12(suppl 9):61.Google Scholar
8.Staud, R, Vierck, CJ, Cannon, RL, Mauderli, AP, Price, DD. Abnormal sensitization and temporal summation of second pain (wind-up) in patients with fibromyalgia syndrome. Pain. 2001;91(1-2):165–175.Google Scholar
9.Staud, R. Evidence of involvement of central neural mechanisms in generating fibromyalgia pain. Curr Rheumatol Rep. 2002;4(4):299–305.CrossRefGoogle ScholarPubMed
10.Russell, IJ. Advances in fibromyalgia: possible role for central neurochemicals. Am J Med Sci. 1998;315(6):377–384.Google Scholar
11.Bennett, RM, Kamin, M, Karim, R, Rosenthal, N. Tramadol and acetaminophen combination tablets in the treatment of fibromyalgia pain: a double-blind, randomized, placebo-controlled study. Am J Med. 2003;114(7):537–545.Google Scholar
12.Caruso, I, Sarzi Puttini, P, Cazzola, M, Azzolini, V. Double-blind study of 5-hydroxy-tryptophan versus placebo in the treatment of primary fibromyalgia syndrome. J Internat Med Res. 1990;18(3):201–209.Google Scholar
13.Goldenberg, D, Mayskiy, M, Mossey, C, Ruthazer, R, Schmid, C. A randomized, double-blind crossover trial of fluoxetine and amitriptyline in the treatment of fibromyalgia. Arthritis Rheum. 1996;39(11):1852–1859.Google Scholar
14.Russell, IJ, Kamin, M, Bennett, RM, Schnitzer, TJ, Green, JA, Katz, WA. Efficacy of tramadol in treatment of pain in fibromyalgia. J Clin Rheumatol. 2000; 6:250–257.Google Scholar
15.Arnold, LM, Hess, EV, Hudson, JI, Welge, JA, Berno, SE, Keck, PE Jr.A randomized, placebo-controlled, double-blind, flexible-dose study of fluoxetine in the treatment of women with fibromyalgia. Am J Med. 2002;112(3):191–197.Google Scholar
16.Arnold, LM, Lu, Y, Crofford, LJ, et al.A double-blind, multicenter trial comparing duloxetine with placebo in the treatment of fibromyalgia patients with or without major depressive disorder. Arthritis Rheum. 2004;50(9):2974–2984.Google Scholar
17.Arnold, LM, Rosen, A, Pritchett, YL, et al.A randomized, double-blind, placebo-controlled trial of duloxetine in the treatment of women with fibromyalgia with or without major depressive disorder. Pain. 2005;119(1-3):5–15.Google Scholar
18.Stratz, T, Farber, L, Varga, B, Baumgartner, C, Haus, U, Muller, W. Fibromyalgia treatment with intravenous tropisetron administration. Drugs Exp Clin Res. 2001;27(3):113–118.Google Scholar
19.Russell, IJ. The promise of substance P inhibitors in fibromyalgia. Rheum Diss Clin North Am. 2002;28(2):329–342.Google Scholar
20.Henriksson, KG, Sorensen, J. The promise of N-methyl-D-aspartate receptor antagonists in fibromyalgia. Rheum Dis Clin North Am. 2002;28(2):343–351.Google Scholar
21.Clark, SR, Bennett, RM. Supplemental dextromethorphan in the treatment of fibromyalgia. A double blind, placebo controlled study of efficacy and side-effects. Arthritis Rheum. 2000;43:333.Google Scholar
22.Dooley, DJ, Donovan, CM, Meder, WP, Whetzel, SZ. Preferential action of gabapentin and pregabalin at P/Q-type voltage-sensitive calcium channels: inhibition of K+-evoked [3H]-norepinephrine release from rat neocortical slices. Synapse. 2002;45(3):171–190.Google Scholar
23.Taylor, CP. Meeting report: the biology and pharmacology of calcium channel proteins Pfizer Satellite Symposium to the 2003 Society for Neuroscience Meeting. Sheraton New Orleans Hotel, New Orleans, LA November 10, 2003. CNS Drug Rev. 2004;10(2):159–164.Google Scholar
24.Crofford, LJ, Rowbotham, MC, Mease, PJ, et al.Pregabalin for the treatment of fibromyalgia syndrome: results of a randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 2006;52(4):1264–1273.CrossRefGoogle Scholar
25.Carter, LP, Flores, LR, Wu, H, et al.The role of GABAB receptors in the discriminative stimulus effects of gamma-hydroxybutyrate in rats: time course and antagonism studies. J Pharmacol Exp Therap. 2003;305(2):668–674.Google Scholar
26.Snead, OC. Evidence for a G protein-coupled gamma-hydroxybutyric acid receptor. J Neurochem. 2000;75:1986–1996.Google Scholar
27.Malawska, B, Kulig, K, Antkiewicz-Michaluk L, Porter R, Misra A, Cliffe IA. Synthesis, physicochemical properties, anticonvulsant activities, and GABA-ergic and voltage-sensitive calcium channel receptor affinities of alpha-substituted N-benzylamides of gamma-hydroxybutyric acid. Part 4: Search for new anticonvulsant compounds. Arch Pharm. 1999;332(5):167–174.Google Scholar
28.Scharf, MB, Hauck, M, Stover, R, McDannold, M, Berkowitz, D. Effect of gamma-hydroxybutyrate on pain, fatigue, and the alpha sleep anomaly in patients with fibromyalgia. Preliminary report. J Rheumatol. 1998;25(10):1986–1990.Google ScholarPubMed
29.Scharf, MB, Baumann, M, Berkowitz, DV. The effects of sodium oxybate on clinical symptoms and sleep patterns in patients with fibromyalgia. J Rheumatol. 2003; 30(5):1070–1074.Google Scholar
30.Russell, IJ, Bennett, RM, Michalek, JE, Oxybate for FMS Study Group. Sodium oxybate relieves pain and improves sleep in fibromyalgia syndrome [FMS]: a randomized, double-blind, placebo-controlled, multi-center clinical trial. Presented at: The 69th Annual Meeting of the American College of Rheumatology; November 12-17, 2005; San Diego, Ca. Abstract 80.Google Scholar