Analgesic Medication in Fibromyalgia Patients: A Cross-Sectional Study

Author:

Aster H.-C.12ORCID,Evdokimov D.1,Braun A.1,Üçeyler N.1ORCID,Sommer C.1ORCID

Affiliation:

1. Department of Neurology, University Hospital Würzburg, Würzburg 97080, Germany

2. Department of Child and Adolescent Psychiatry, Psychotherapy and Psychsomatics, University Hospital Würzburg, Würzburg 97080, Germany

Abstract

There is no approved drug for fibromyalgia syndrome (FMS) in Europe. In the German S3 guideline, amitriptyline, duloxetine, and pregabalin are recommended for temporary use. The aim of this study was to cross-sectionally investigate the current practice of medication in FMS patients in Germany. We systematically interviewed 156 patients with FMS, while they were participating in a larger study. The patients had been stratified into subgroups with and without a decrease in intraepidermal nerve fiber density. The drugs most commonly used to treat FMS pain were nonsteroidal anti-inflammatory drugs (NSAIDs) (41.0% of all patients), metamizole (22.4%), and amitriptyline (12.8%). The most frequent analgesic treatment regimen was “on demand” (53.9%), during pain attacks, while 35.1% of the drugs were administered daily and the remaining in other regimens. Median pain relief as self-rated by the patients on a numerical rating scale (0–10) was 2 points for NSAIDS, 2 for metamizole, and 1 for amitriptyline. Drugs that were discontinued due to lack of efficacy rather than side effects were acetaminophen, flupirtine, and selective serotonin reuptake inhibitors. Reduction in pain severity was best achieved by NSAIDs and metamizole. Our hypothesis that a decrease in intraepidermal nerve fiber density might represent a neuropathic subtype of FMS, which would be associated with better effectiveness of drugs targeting neuropathic pain, could not be confirmed in this cohort. Many FMS patients take “on-demand” medication that is not in line with current guidelines. More randomized clinical trials are needed to assess drug effects in FMS subgroups.

Funder

Else Kröner-Fresenius Stiftung

Publisher

Hindawi Limited

Subject

Anesthesiology and Pain Medicine,Neurology

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