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 .
An open-label study of quetiapine in the treatment of fibromyalgia
The aim of this exploratory study was to systematic ally assess the potential effectiveness and tolerability of quetiapine , an atypical antipsychotic , for the treatment of patients with fibromyalgia . This was a unicentre , open-label study conducted in thirty-five out patients , 18 years or older , who met the ACR criteria for fibromyalgia and who had not satisfactorily responded to their previous fibromyalgia treatment .  Quetiapine , flexibly dosed ( 25 - 100 mg/day ) , was added to their original treatment regimen for 12 weeks . The primary outcome measure was the mean change from baseline to endpoint in the Fibromyalgia Impact Question naire ( FIQ ) total score . Secondary efficacy measures included mean changes from baseline to endpoint in the scores of the Clinical Global Impression ( CGI ) of Severity scale , Pittsburgh Sleep Quality Index ( PSQI ) , Beck Depression Inventory ( BDI ) , State-Trait Anxiety Inventory ( STAI ) , 12-Item Short Form Health Survey ( SF-12 ) , and individual items of the FIQ .  Thirty ( 85.7 % ) patients ( mean age 47+/-7.9 , 93.3 % females ) had a postbaseline evaluation and constituted the intent-to-treat efficacy sample . Mean FIQ total score decreased significantly by 10.2 points from a baseline of 63.2 to 53.0 at study endpoint ( p<0.001 ) . A statistically significant reduction was observed in FIQ stiffness and FIQ fatigue subscores but not in FIQ pain subscore . Large effect sizes were observed for the FIQ total ( 1.04 ) , CGI-severity ( 1.00 ) and PSQI ( 1.07 ) , while moderate effect sizes ( i.e. > or = 0.50 ) were encountered in the FIQ fatigue , FIQ stiffness and SF-12 mental component summary .  Quetiapine was safely administered and well tolerated . Despite the lack of effect on pain , the significant and relevant improvement in overall efficacy measures and quality of life suggests that quetiapine may be a valuable drug for treatment of patients with fibromyalgia that should be further tested in double-blind , placebo-controlled trials
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 .