Study Reveals Wide Range of Treatments Used for Fibromyalgia

Karen Lee Richards Health Guide
  • A new study published in the October 2012 issue of Pain Medicine investigated the burden of illness and treatment patterns in 1,700 patients with fibromyalgia from July 2008 through May 2010 in 58 care settings in the U.S. and Puerto Rico.


    Despite the fact that only three drugs have received FDA approval for the treatment of FM (Lyrica, Cymbalta and Savella), investigators discovered that the patients in the study were taking 182 different prescription medications and using 17 nonpharmacologic treatments.


    The top 11 drugs or drug classes being prescribed included:

    • Cymbalta (duloxetine) – 26.8%

    • Nonsteroidal anti-inflammatory drugs (NSAIDs) – 26.6%

    • Lyrica (pregabalin) – 24.5%

    • Opioids – 24.2%

    • Ultram (tramadol) – 15.3%

    • Benzodiazepines – 15.2%

    • Selective serotonin reuptake inhibitors (SSRIs) – 13.1%

    • Flexaril (cyclobenzaprine) – 12.9%

    • Nonbenzodiazepine sedative/hypnotics – 12.9%

    • Neurontin (gabapentin) – 11.2%

    • Savella (milnacipran) – 8.9%


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    Most of the patients (78%) reported taking more than one medication concurrently for their FM symptoms, with the average being two to four medications. The medications prescribed were strongly associated with the patient's medication history and the medical specialty of the prescriber. Specialists tended to prescribe the three newly approved FM medications more frequently.


    The most common nonpharmacologic therapies used were rest, exercise, massage, counseling, and heat/cold modalities. Only 4.5% of patients had used cognitive behavioral therapy while 27% had received trigger-point injections. Prayer/meditation and cognitive distraction were also frequently used.


    My Thoughts...


    It should be pointed out that this study was funded by Eli Lilly and Company, the manufacturers of Cymbalta, and the study began in July 2008––the same month Cymbalta received FDA approval. So the fact that Cymbalta tops the list of prescribed medications may have something to do with the natural promotion of a new drug on the market. Also, the fact that Savella was not approved until March, 2009––almost halfway through the study––could explain the relatively low percentage of people reported to be taking it.


    Despite those caveats, it is clear that even though we now have three medications approved for treating FM, finding the most effective treatment combination for each individual FM patient is still largely a matter of trial and error. I knew that doctors were still prescribing a variety of different medications for FM patients since the approved drugs are only effective for about 30-40% of people, but I have to admit I was surprised to see 182 different medications. It's no wonder that for so many people with FM, finding that ideal treatment combo is such a long and frustrating journey.


    How many different medications and other therapies have you tried? Which have helped you the most?




    Robinson RL, et al. “Burden of Illness and Treatment Patterns for Patients with Fibromyalgia.” Pain Medicine. 2012;13:1366-1376.

  • Leavitt SB. “The Profusion of Fibromyalgia Therapies Studied.” October 19, 2012.

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Published On: October 31, 2012