Giorgi Valeria, Sarzi-Puttini Piercarlo, Pellegrino Greta, Sirotti Silvia, Atzeni Fabiola, Alciati Alessandra, Torta Riccardo, Varrassi Giustino, Fornasari Diego, Coaccioli Stefano, Bongiovanni Sara Francesca
Unità di Ricerca Clinica, Gruppo Ospedaliero Moncucco, Via Soldino, 5, 6900, Lugano, CH, Switzerland.
Rheumatology Unit, IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy.
Curr Pain Headache Rep. 2024 Dec;28(12):1349-1363. doi: 10.1007/s11916-024-01277-9. Epub 2024 Jul 23.
Fibromyalgia Syndrome (FMS) is a complex chronic pain condition characterized by widespread musculoskeletal pain and numerous other debilitating symptoms. The purpose of this review is to provide a comprehensive overview, based on everyday clinical practice, of the drugs presently employed in the treatment of FMS.
The treatment of FMS is based on a multimodal approach, with pharmacologic treatment being an essential pillar. The drugs used include tricyclic antidepressants, serotonin and noradrenaline reuptake inhibitors, other antidepressants, anticonvulsants, myorelaxants, and analgesics. The effectiveness of these medications varies, and the choice of drug often depends on the specific symptoms presented by the patient. Many drugs tend to either address only some domains of the complex FMS symptomatology or have a limited effect on pain. Each treatment option comes with potential side effects and risks that necessitate careful consideration. It may be beneficial to divide patients into clinical subpopulations, such as FMS with comorbid depression, for more effective treatment. Despite the complexities and challenges, the pharmacological treatment remains a crucial part for the management of FMS. This review aims to guide clinicians in prescribing pharmacological treatment to individuals with FMS.
纤维肌痛综合征(FMS)是一种复杂的慢性疼痛病症,其特征为广泛的肌肉骨骼疼痛及众多其他使人衰弱的症状。本综述的目的是基于日常临床实践,全面概述目前用于治疗FMS的药物。
FMS的治疗基于多模式方法,药物治疗是重要支柱。所使用的药物包括三环类抗抑郁药、5-羟色胺和去甲肾上腺素再摄取抑制剂、其他抗抑郁药、抗惊厥药、肌松药和镇痛药。这些药物的疗效各不相同,药物的选择通常取决于患者呈现的具体症状。许多药物往往仅能解决复杂的FMS症状学的某些方面,或对疼痛的影响有限。每种治疗方案都有潜在的副作用和风险,需要仔细考虑。将患者分为临床亚组,如伴有共病抑郁的FMS,可能有助于更有效的治疗。尽管存在复杂性和挑战,但药物治疗仍是FMS管理的关键部分。本综述旨在指导临床医生为FMS患者开具药物治疗处方。