As of this writing, three medications have been approved by the FDA for the treatment of fibromyalgia: Lyrica (pregabalin), Cymbalta (duloxetine) and Savella (milnacipran). Since all three are relatively new drugs, information on how well they work and their side effects is still being gathered. Because every patient's symptoms and body chemistry are different, it is often a matter of trial and error to find the best medication for a particular patient with a particular illness. However, a recent German study , which was the first to compare the pros and cons of the three drugs head-to-head, may help doctors choose which medication has the best chance of success for any given patient. Study Design The study authors searched MEDLINE, SCOPUS, Cochrane Central Register of Controlled Trials, and sought unpublished data from the databases of FDA, US National Institutes for Health, and Industry through May 2009 for randomized controlled trials. They found 17...
Recently I wrote about the anti-seizure medication, Topamax, for chronic headache pain. Today, I would like to discuss another medication which has also been used to treat seizures: Lyrica. This has been on the market for less than a year, but I have found it a very helpful drug in patients with chronic pain syndromes, such as fibromyalgia. Fibromyalgia occurs predominantly in women of child-bearing age, and is seen commonly in the offices of most rheumatologists in the United States. Afflicted patients usually complain of diffuse musculoskeletal pain, poor sleep, and fatigue. Often, the amount of pain is related to the amount of sleep—the less sleep, the more pain. Many patients feel their pain is worsened by stress, cold weather, or overexertion. Conversely, patients will feel better in warm weather, while on vacation and away from the usual worries of day to day living, and with improved sleep hygiene. Patients will often suffer from chronic headaches and an irritable bowel.
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) &nd...
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