Fibromyalgia affects more than 5 million Americans, primarily women. According to a review published in The Cochrane Library, two medications commonly prescribed to relieve fibromyalgia pain help some patients, but cause problems for others. Cymbalta (duloxetine) and Savella (milnacipran) had a small incremental effect over placebo in reducing pain. The number of patients who had to stop the drugs due to adverse events was higher for Cymbalta and Savella than for placebo. The drugs were not much better than placebo in reducing fatigue and limitations of quality of life.
Ten studies involving more than 6,000 fibromyalgia patients who were given Cymbalta, Savella, or placebo for up to 6 months were reviewed. Researchers concluded that the drugs should not be prescribed alone for fibromyalgia. An approach that would utilize medications in patients who find them helpful, exercise to improve mobility, and counseling to improve coping skills was recommended in place of medication alone. Later this year, The Cochrane Library is expected to publish a review of Lyrica (pregabalin), the other medication approved for fibromyalgia in the U.S.
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