Pharmacotherapy for fibromyalgia has become more prevalent in clinical practice as our understanding of the cellular, molecular and pathophysiologic mechanisms contributing to widespread musculoskeletal and neuropathic pain has evolved. Thus, several pain pathways including high-voltage activated Ca2+ channels and the Kv1 family of K+ ion channels appear related to the efficacy of pregabalin and amitriptyline, respectively. Serotonin and norepinephrine reuptake inhibitors - including mirtazapine, duloxetine and milnacipran - appear to be more efficacious in FMS than selective serotonin reuptake inhibitors.
Fibromyalgia Pain Reduced by Low-Dose Naltrexone
Low-dose naltrexone (LDN) has been found to be an effective, highly tolerable, and inexpensive treatment to reduce daily pain in patients with fibromyalgia, according to the results of a placebo-controlled, double-blind trial, reported at the American Academy of Pain Medicine’s 28th Annual Meeting in February, 2012. At the end of the trial, patients reported a 43% reduction in pain during the LDN treatment when compared to the placebo treatment.