Cymbalta (duloxetine) and Savella (milnacipran) were the second and third medications to receive FDA approval for the treatment of fibromyalgia. Both are serotonin and noradrenaline reuptake inhibitors (SNRIs).
According to a new review published in The Cochrane Library, among FM patients taking either of the two drugs, 22% report substantial improvement while 21% had to quit taking them due to unpleasant side effects. Since almost equal numbers of people were helped as were harmed, this brings up the question of whether these medications are worth trying, especially considering their high cost.
Following is The Cochran Library's “plain language summary” of the results of this study:
Serotonin and noradrenaline reuptake inhibitors for fibromyalgia Researchers in the Cochrane Collaboration conducted a review of research about the effects of serotonin and noradrenaline reuptake inhibitors (SNRIs) on fibromyalgia syndrome (FMS). After searching for all rel...
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...
Treatment Fibromyalgia is a mysterious condition. Its causes are still largely unknown, as is how it causes damage. No strong evidence indicates that any single treatment (or combination of treatments) has any significant effect for most patients. In 2007 pregabalin (Lyrica) became the first drug FDA-approved for the treatment of fibromyalgia, after a study showed the medicine reduced fibromyalgia pain in 63% of patients. A year later, the FDA approved the drug duloxetine (Cymbalta) for fibromyalgia. Cymbalta has been shown to reduce fibromyalgia pain by more than 30%. The serotonin-norepinephrine reuptake inhibitor (SNRI) milnacipran (Savella) is also approved for this condition. Many patients with fibromyalgia are treated first with medication; however, the American Pain Society Fibromyalgia Panel recommends a combined approach using cognitive-behavioral therapy, education, medication, and exercise. Treatment usually involves not only relieving symptoms but also changing a patient's at...
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