Objective. To assess for familial aggregation of fibromyalgia (FM) and measures of tenderness and pain, and for familial coaggregation of FM and major mood disorder (major depressive disorder or bipolar disorder).Methods. Probands meeting the American College of Rheumatology criteria for FM and control probands with rheumatoid arthritis (RA) and no lifetime diagnosis of FM were recruited from consecutive referrals to 2 community-based rheumatology practices. Probands were ages 40-55 years and had at least 1 firstdegree relative age 18 years or older who was available for interview and examination. All probands and interviewed relatives underwent a dolorimeter tender point examination and a structured clinical interview. Interviewed relatives were asked about first-degree relatives who were not available for interview, using a structured family interview. Logistic and linear regression models, adjusting for the correlation of observation within families, were applied to study the aggregation and coaggregation effects.Results. Information was collected for 533 relatives of 78 probands with FM and 272 relatives of 40 probands with RA. FM aggregated strongly in families: the odds ratio (OR) measuring the odds of FM in a relative of a proband with FM versus the odds of FM in a relative of a proband with RA was 8.5 (95% confidence interval [95% CI] 2.8-26, P ‫؍‬ 0.0002). The number of tender points was significantly higher, and the total myalgic score was significantly lower in the relatives of probands with FM compared with the relatives of probands with RA. FM coaggregated significantly with major mood disorder: the OR measuring the odds of major mood disorder in a relative of a proband with FM versus the odds of major mood disorder in a relative of a proband with RA was 1.8 (95% CI 1.1-2.9, P ‫؍‬ 0.013).Conclusion. FM and reduced pressure pain thresholds aggregate in families, and FM coaggregates with major mood disorder in families. These findings have important clinical and theoretical implications, including the possibility that genetic factors are involved in the etiology of FM and in pain sensitivity. In addition, mood disorders and FM may share some of these inherited factors.Fibromyalgia (FM) is a disorder of unknown etiology and is defined by the American College of Rheumatology (ACR) as widespread pain of at least 3 months duration in combination with tenderness at 11 or more of 18 specific tender point sites on the body (1). Other characteristic symptoms of FM include fatigue, sleep disturbance, and morning stiffness (1). It is not known whether FM aggregates in families. Three studies found an elevated prevalence of FM in first-degree relatives of probands with FM (2-4). In the first of those studies, 26 (50%) of 50 parents and siblings of 17 probands had FM (2). However, standard criteria for the diagnosis of FM were not used, and the number of relatives who chose not to participate was not reported. More recently, Buskila et al reported that 16 (28%) of the 58 children of 20 women with FM were diagnose...

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Objective. To assess the efficacy and safety of gabapentin in patients with fibromyalgia.Methods. A 12-week, randomized, double-blind study was designed to compare gabapentin (1,200-2,400 mg/day) (n ‫؍‬ 75 patients) with placebo (n ‫؍‬ 75 patients) for efficacy and safety in treating pain associated with fibromyalgia. The primary outcome measure was the Brief Pain Inventory (BPI) average pain severity score (range 0-10, where 0 ‫؍‬ no pain and 10 ‫؍‬ pain as bad as you can imagine). Response to treatment was defined as a reduction of >30% in this score. The primary analysis of efficacy for continuous variables was a longitudinal analysis of the intent-to-treat sample, with treatment-by-time interaction as the measure of effect.Results. Gabapentin-treated patients displayed a significantly greater improvement in the BPI average pain severity score (P ‫؍‬ 0.015; estimated difference between groups at week 12 ‫؍‬ ؊0.92 [95% confidence interval ؊1.75, ؊0.71]). A significantly greater proportion of gabapentin-treated patients compared with placebo-treated patients achieved response at end point (51% versus 31%; P ‫؍‬ 0.014). Gabapentin compared with placebo also significantly improved the BPI average pain interference score, the Fibromyalgia Impact Questionnaire total score, the Clinical Global Impression of Severity, the Patient Global Impression of Improvement, the Medical Outcomes Study (MOS) Sleep Problems Index, and the MOS Short Form 36 vitality score, but not the mean tender point pain threshold or the Montgomery Asberg Depression Rating Scale. Gabapentin was generally well tolerated.Conclusion. Gabapentin (1,200-2,400 mg/day) is safe and efficacious for the treatment of pain and other symptoms associated with fibromyalgia.Fibromyalgia is a common, chronic musculoskeletal pain disorder that is characterized by widespread pain and tenderness and is frequently accompanied by fatigue, insomnia, depression, and anxiety (1,2). Fibromyalgia occurs in ϳ2% of the US general population, is more common in women (3.4% of women and 0.5% of men) (3), and is associated with substantial morbidity and disability.

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