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 .
Improvement in multiple dimensions of fatigue in patients with fibromyalgia treated with duloxetine: secondary analysis of a randomized, placebo-controlled trial
Introduction Fatigue is one of the most disabling symptoms associated with fibromyalgia that greatly impacts quality of life . Fatigue was assessed as a secondary objective in a 2-phase , 24-week study in out patients with American College of Rheumatology-defined fibromyalgia . Methods Patients were r and omized to duloxetine 60 - 120 mg/d ( N = 263 ) or placebo ( N = 267 ) for the 12-week acute phase . At Week 12 , all placebo-treated patients were switched to double-blind treatment with duloxetine for the extension phase . Fatigue was assessed at baseline and every 4 weeks with the Multidimensional Fatigue Inventory ( MFI ) scales : General Fatigue , Physical Fatigue , Mental Fatigue , Reduced Activity , and Reduced Motivation . Other assessment s that may be associated with fatigue included Brief Pain Inventory ( BPI ) average pain , numerical scales to rate anxiety , depressed mood , bothered by sleep difficulties , and musculoskeletal stiffness . Treatment-emergent fatigue-related events were also assessed . Changes from baseline to Week 12 , and from Week 12 to Week 24 , were analyzed by mixed-effects model repeated measures analysis . Results At Week 12 , duloxetine versus placebo significantly ( all p < .05 ) reduced ratings on each MFI scale , BPI pain , anxiety , depressed mood , and stiffness . Improvement in ratings of being bothered by sleep difficulties was significant only at Weeks 4 and 8 . At Week 24 , mean changes in all measures indicated improvement was maintained for patients who received duloxetine for all 24 weeks ( n = 176 ) . Placebo-treated patients switched to duloxetine ( n = 187 ) had significant within-group improvement in Physical Fatigue ( Weeks 16 , 20 , and 24 ) ; General Fatigue ( Weeks 20 and 24 ) ; Mental Fatigue ( Week 20 ) ; and Reduced Activity ( Weeks 20 and 24 ) . These patients also experienced significant within-group improvement in BPI pain , anxiety , depressed mood , bothered by sleep difficulties , and stiffness . Overall , the most common ( > 5 % incidence ) fatigue-related treatment-emergent adverse events were fatigue , somnolence , and insomnia . Conclusions Treatment with duloxetine significantly improved multiple dimensions of fatigue in patients with fibromyalgia , and improvement was maintained for up to 24 weeks . Trial registration Clinical Trials.gov registry NCT00673452
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 .