While no clinical trial to date has specifically targeted fatigue , r and omized controlled trials , systematic review s , and meta-analyses indicate that treatment modalities studied in the context of other fibromyalgia symptoms could also improve fatigue .
Fatigue is a disabling , multifaceted symptom that is highly prevalent and stubbornly persistent .
Although fatigue is a frequent complaint among patients with fibromyalgia , it has not received the same attention as pain .
Reasons for this include lack of st and ardized nomenclature to communicate about fatigue , lack of evidence -based guidelines for fatigue assessment , and a deficiency in effective treatment strategies .
Fatigue does not occur in isolation ; rather , it is present concurrently in varying severity with other fibromyalgia symptoms such as chronic widespread pain , unrefreshing sleep , anxiety , depression , cognitive difficulties , and so on .
Survey-based and preliminary mechanistic studies indicate that multiple symptoms feed into fatigue and it may be associated with a variety of physiological mechanisms .
Efficacy of milnacipran in patients with fibromyalgia.
OBJECTIVE Fibromyalgia ( FM ) is a common musculoskeletal condition characterized by widespread pain , tenderness , and a variety of other somatic symptoms . Current treatments are modestly effective . Arguably , the best studied and most effective compounds are tricyclic antidepressants ( TCA ) . Milnacipran , a nontricyclic compound that inhibits the reuptake of both serotonin and norepinephrine , may provide many of the beneficial effects of TCA with a superior side effect profile . METHODS One hundred twenty-five patients with FM were r and omly assigned in a 3:3:2 ratio to receive milnacipran twice daily , milnacipran once daily , or placebo for 3 months in a double-blind dose-escalation trial ; 92 % of twice-daily and 81 % of once-daily participants achieved dose escalation to the target milnacipran dose of 200 mg . RESULTS The primary endpoint was reduction of pain . Both the once- and twice-daily groups showed statistically significant improvements in pain , as well as improvements in global well being , fatigue , and other domains . Response rates for patients receiving milnacipran were equal in patients with and without comorbid depression , but placebo response rates were considerably higher in depressed patients , leading to significantly greater overall efficacy in the nondepressed group . CONCLUSION In this Phase II study , milnacipran led to statistically significant improvements in pain and other symptoms of FM . The effect sizes were equal to those previously found with TCA , and the drug was generally well tolerated
While no clinical trial to date has specifically targeted fatigue , r and omized controlled trials , systematic review s , and meta-analyses indicate that treatment modalities studied in the context of other fibromyalgia symptoms could also improve fatigue .
Fatigue is a disabling , multifaceted symptom that is highly prevalent and stubbornly persistent .
Although fatigue is a frequent complaint among patients with fibromyalgia , it has not received the same attention as pain .
Reasons for this include lack of st and ardized nomenclature to communicate about fatigue , lack of evidence -based guidelines for fatigue assessment , and a deficiency in effective treatment strategies .
Fatigue does not occur in isolation ; rather , it is present concurrently in varying severity with other fibromyalgia symptoms such as chronic widespread pain , unrefreshing sleep , anxiety , depression , cognitive difficulties , and so on .
Survey-based and preliminary mechanistic studies indicate that multiple symptoms feed into fatigue and it may be associated with a variety of physiological mechanisms .