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 .
Longterm Therapeutic Response to Milnacipran Treatment for Fibromyalgia. A European 1-Year Extension Study Following a 3-Month Study
Objective . This double-blind , 1-year extension study investigated the longterm efficacy and safety of milnacipran 100 , 150 , and 200 mg/day in the treatment of fibromyalgia ( FM ) in completers of a 3-month European double-blind lead-in study of milnacipran 200 mg/day versus placebo . Methods . A total of 468 patients with FM successfully completing the lead-in study were either blindly maintained on milnacipran 200 mg/day ( MLN200:MLN200 , n = 198 ) or ( if previously receiving placebo ) rer and omized to milnacipran 100 mg/day ( PBO : MLN100 , n = 91 ) , 150 mg/day ( PBO : MLN150 , n = 92 ) , or 200 mg/day ( PBO : MLN200 , n = 87 ) for an additional 12 months ( including a 4-week dose escalation ) . The main efficacy endpoint was a 2-measure composite responder rate ( relative to lead-in study baseline ) incorporating the weekly-recall pain score recorded on a visual analog scale and the Patient Global Impression of Change score . A panel of other assessment s including the Fibromyalgia Impact Question naire explored the multidimensional aspects of FM . Descriptive analyses using the last observation carried forward approach were performed . Results . At the 1-year endpoint , the proportion of composite responders ( relative to the lead-in study baseline ) ranged from 27.5 % ( PBO : MLN100 ) to 35.9 % ( MLN200:MLN200 ) , and had increased from the extension study baseline by 15.2 % ( PBO : MLN150 ) to 20.7 % ( PBO : MLN200 and MLN200:MLN200 ) . At endpoint , an improvement from both baselines was shown in all groups on pain , fatigue , sleep , and quality of life measures . Up to 1 year , all doses of milnacipran were safe and well tolerated . The most common drug-related adverse events were hyperhidrosis and nausea . Conclusion . Over 1 year , milnacipran 100 , 150 , and 200 mg/day exhibited sustained and safe therapeutic effects on predominant symptoms of FM . Registered as trial no. NCT00757731
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 .