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 and safety of milnacipran 100 mg/day in patients with fibromyalgia: results of a randomized, double-blind, placebo-controlled trial.
OBJECTIVE To assess the efficacy and safety of milnacipran at a dosage of 100 mg/day ( 50 mg twice daily ) for monotherapy treatment of fibromyalgia . METHODS A double-blind , placebo-controlled trial was performed to assess 1,025 patients with fibromyalgia who were r and omized to receive milnacipran 100 mg/day ( n = 516 ) or placebo ( n = 509 ) . Patients underwent 4 - 6 weeks of flexible dose escalation followed by 12 weeks of stable-dose treatment . Two composite responder definitions were used as primary end points to classify the response to treatment . The 2-measure composite response required achievement of ≥30 % improvement from baseline in the pain score and a rating of " very much improved " or " much improved " on the Patient 's Global Impression of Change ( PGIC ) scale . The 3-measure composite response required satisfaction of these same 2 improvement criteria for pain and global status as well as improvement in physical function on the Short Form 36 ( SF-36 ) physical component summary ( PCS ) score . RESULTS After 12 weeks of stable-dose treatment , a significantly greater proportion of milnacipran-treated patients compared with placebo-treated patients showed clinical ly meaningful improvements , as evidence d by the proportion of patients meeting the 2-measure composite responder criteria ( P < 0.001 in the baseline observation carried forward [ BOCF ] analysis ) and 3-measure composite responder criteria ( P < 0.001 in the BOCF ) . Milnacipran-treated patients also demonstrated significantly greater improvements from baseline on multiple secondary outcomes , including 24-hour and weekly recall pain score , PGIC score , SF-36 PCS and mental component summary scores , average pain severity score on the Brief Pain Inventory , Fibromyalgia Impact Question naire total score ( all P < 0.001 versus placebo ) , and Multidimensional Fatigue Inventory total score ( P = 0.036 versus placebo ) . Milnacipran was well tolerated by most patients , with nausea being the most commonly reported adverse event ( placebo-adjusted rate of 15.8 % ) . CONCLUSION Milnacipran administered at a dosage of 100 mg/day improved pain , global status , fatigue , and physical and mental function in patients with fibromyalgia
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 .