CBTs provided a small incremental benefit over control interventions in reducing pain , negative mood and disability at the end of treatment and at long-term follow-up .
The dropout rates due to any reason did not differ between CBTs and controls
BACKGROUND Fibromyalgia ( FM ) is a clinical ly well-defined chronic condition of unknown aetiology characterized by chronic widespread pain that often co-exists with sleep disturbances , cognitive dysfunction and fatigue .
Patients often report high disability levels and negative mood .
Psychotherapies focus on reducing key symptoms , improving daily functioning , mood and sense of personal control over pain .
OBJECTIVES To assess the benefits and harms of cognitive behavioural therapies ( CBTs ) for treating FM at end of treatment and at long-term ( at least six months ) follow-up .
Short-term (2-week) effects of discontinuing milnacipran in patients with fibromyalgia
Abstract Objective : To examine the effects of abruptly withdrawing  milnacipran during the 2-week discontinuation phase of a study in which FM patients had received 12 weeks of stable-dose treatment with milnacipran at 100 mg/day . Research design and methods : The effects of withdrawing milnacipran were evaluated prospect ively over a 2-week period ( Weeks 12 to 14 ) using a r and omized , placebo-controlled withdrawal design . Patients who had originally received milnacipran 100 mg/d for 12 weeks were re-r and omized to continue milnacipran ( n = 178 ) or switch directly to placebo ( n = 178 ) ; patients originally receiving placebo continued placebo ( n = 359 ) . Clinical trial registration : Clinical strials.gov ( NCT00314249 ) . Main outcome measures : Loss of efficacy was evaluated by mean changes in pain and functional measures and by percentage of composite responders , defined as patients with simultaneous improvements in pain , global status , and physical functioning . Newly emergent adverse events and changes in vital signs were also recorded . Results : Within 2 weeks , patients switched from milnacipran to placebo had greater mean worsening in pain , functioning , and global status measures when compared with patients continuing treatment . In addition , significantly fewer composite responders were found in patients who discontinued active treatment than in patients who continued receiving milnacipran ( 22.0 % vs 32.3 % , p < 0.05 ) . Incidences of newly emergent adverse events were 16.3 % and 18.0 % in patients discontinuing and continuing treatment , respectively . Mean vital sign changes decreased or returned to baseline within 2 weeks of discontinuation . Conclusions : Patients discontinuing milnacipran experienced worsening in multiple efficacy parameters within 2 weeks . Vital sign changes observed with milnacipran during the 12-week stable-dose period decreased or returned to baseline values within 2 weeks after discontinuation of treatment . No new safety concerns were found during this discontinuation period with milnacipran
CBTs provided a small incremental benefit over control interventions in reducing pain , negative mood and disability at the end of treatment and at long-term follow-up .
The dropout rates due to any reason did not differ between CBTs and controls
BACKGROUND Fibromyalgia ( FM ) is a clinical ly well-defined chronic condition of unknown aetiology characterized by chronic widespread pain that often co-exists with sleep disturbances , cognitive dysfunction and fatigue .
Patients often report high disability levels and negative mood .
Psychotherapies focus on reducing key symptoms , improving daily functioning , mood and sense of personal control over pain .
OBJECTIVES To assess the benefits and harms of cognitive behavioural therapies ( CBTs ) for treating FM at end of treatment and at long-term ( at least six months ) follow-up .