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Carol Eustice

Two Fibromyalgia Medications Don't Stand Out When Compared to Placebo

By February 21, 2013

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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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Comments
February 22, 2013 at 12:31 pm
(1) Wilts lass says:

I wouldnt recommend Lyrica either. i was given this for neuropathic pain which is what it has been used for longer term. This had no effect on my pain, but disturbed my speech such that I was swopping nouns! Felt like I was going mad, so had to come off it pretty quickly.

Having a positive attitude seems to be the best option so far for me :)

February 22, 2013 at 12:46 pm
(2) Kelly Latta says:

There are always difficulties with meta analysis. Studies may or may not have been studying the same patients which would affect the outcome as would how endpoints were determined and what instruments were used. For example many physical symptoms of fibromyalgia can be mistaken for symptoms of mental illness. The removal of objective criteria (tender points) in 2010 makes this even more likely.

Many times in a clinical setting side effects can be mitigated if the patient works with a prescriber to optimize the medication. It also should be noted that side effects were not fatal or life threatening.

Although fibromyalgia is being proposed as a psychiatric spectrum disorder, it should also be noted that the Cochrane group doing the review was in the Cochrane Musculoskeletal Group.

February 25, 2013 at 2:38 pm
(3) Ivy says:

Anyone who thinks fibromyalgia is a psychiatric disorder is living in the Stone Age. It is a neurological disorder. There is a huge difference!

February 27, 2013 at 11:52 am
(4) Terry says:

I also tried both Cymbalta as well as Lyrica for severe fibromyalgia. Neither had any effect on my pain levels and the side effects were numerous. These included increased fatigue, anxiety, weight gain, just to name a few. My reumatologist then put me on Gabapentin, also known as Neurontin, and it has made a huge difference in my pain levels and ability to function. I have gradually began increasing my exercise, even after two knee replacements, and I am having fewer and much less severe flare ups. My brain fog is greatly decreased as well, which is probably related to my increased activity level. Just wanted to share my story in case someone else out there may be helped by this medication as well.

February 27, 2013 at 3:54 pm
(5) barb says:

I have been on gabapentin for my fibro for several years,I swear by it,it not only works but doesn’t break the bank to buy it.I would highly recommend it,

February 27, 2013 at 8:25 pm
(6) JudyP says:

I was on Lyrica for a number of years for fms and it was wonderful for the pain. Unfortunately, I had the side effect of suicidal thoughts, so had to reduce the dose and add Savella. Had a good regimen, but my insurance company raised the co-pays, so now I’m starting from scratch with other meds. It’s all complicated by OA and meralgia parasthetica (horrid pain on the outside and front of my thighs caused by an impinged sensory nerve called the lateral femoral cutaneous nerve) that is wreaking havoc with my pain levels right now. Ironically, one of the new meds I’m using is Lidoderm patches, but they are, literally, a temporary patch, and costing the insurance carrier twice what my other regimen was costing. Go figure.

March 3, 2013 at 7:29 pm
(7) jen says:

I found Cymbalta increased my energy level, and Lyrica has done wonders for my pain. I’m lucky to not have too many side effects. These meds have made it so I am able to get out and do the recommended gentle exercise whereas without them I couldn’t.

April 6, 2013 at 4:25 pm
(8) sunny says:

Tried many types of drugs.None help much,side effects worse than not taking them.Just have to live and move on.

July 29, 2013 at 7:24 am
(9) jenn says:

cymbalta made me suicidal, fun times and savella caused me to be allergic to the sun with severe hive outbreaks, both meds cost $200 a month and would only work when i wasn’t ovulating or having my period. :(

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