Han C, Lee S-J, Lee S-Y, Seo H-J, Wang S-M, Park M-H, Patkar A A, Koh J, Masand P S, Pae C-U
Department of Psychiatry, Korea University, Seoul, Republic of Korea.
Drugs Today (Barc). 2011 Jul;47(7):539-57. doi: 10.1358/dot.2011.47.7.1603503.
Fibromyalgia (FM) is a chronic medical condition characterized by physical, psychiatric and psychological symptoms. Widespread pain, fatigue, sleep disturbances, heightened sensitivity, morning stiffness, decreased volition, depressed mood and a history of early abuse are frequently reported by patients with FM. Treatment of fibromyalgia is multidisciplinary, with an emphasis on active patient participation, medications, cognitive-behavioral therapy and physical modalities. No single medication has yet been found to sufficiently control all the symptoms of FM; currently available medication classes include antidepressants, nonsteroidal anti-inflammatory drugs, opioids, sedatives, muscle relaxants, analgesics, hypnotic agents and anticonvulsants. Hence, treatment for patients with FM, including pharmacological and non-pharmacological approaches, should be individualized based on each patient's clinical history, target symptoms and functional impairments. Although nonpharmacological modalities are also frequently used, recent research has focused on identifying more effective pharmacological treatments, particularly antidepressants and anticonvulsants. Furthermore, several new pharmacological agents have been now officially approved for the treatment of patients with FM. Thus, the purpose of this review is to help healthcare professionals make informed decisions about the appropriate use of a number of pharmacological treatments for patients with FM.
纤维肌痛(FM)是一种慢性疾病,其特征为身体、精神和心理症状。纤维肌痛患者经常报告广泛疼痛、疲劳、睡眠障碍、高度敏感、晨僵、意志减退、情绪低落以及早期受虐史。纤维肌痛的治疗是多学科的,重点是患者积极参与、药物治疗、认知行为疗法和物理治疗方式。尚未发现单一药物能充分控制纤维肌痛的所有症状;目前可用的药物类别包括抗抑郁药、非甾体抗炎药、阿片类药物、镇静剂、肌肉松弛剂、镇痛药、催眠药和抗惊厥药。因此,纤维肌痛患者的治疗,包括药物和非药物方法,应根据每个患者的临床病史、目标症状和功能损害进行个体化。尽管非药物治疗方式也经常使用,但最近的研究集中在确定更有效的药物治疗方法,特别是抗抑郁药和抗惊厥药。此外,现在有几种新药已被正式批准用于治疗纤维肌痛患者。因此,本综述的目的是帮助医疗保健专业人员就纤维肌痛患者多种药物治疗的适当使用做出明智的决定。