Present state of medication therapy in fibromyalgia syndrome

Lautenschläger, J

doi:10.1080/030097400446616

Cited by 43 publications

(18 citation statements)

References 25 publications

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“…However, there is little evidence of the efficacy of medications after prolonged use and treatment effects often disappear after discontinuation and may result in 'rebound insomnia' that can lead to dependence [25]. Common side effects of hypnotic and tricyclic medication (such as drowsiness and confusion) can also exacerbate other symptoms of the condition such as fatigue and cognitive difficulties and may not be well tolerated by some patients [26,27].…”

Section: Introductionmentioning

confidence: 99%

‘This constant being woken up is the worst thing’ – experiences of sleep in fibromyalgia syndrome

Theadom

Cropley

2010

Disability and Rehabilitation

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Theadom A, Cropley M (2010). 'This constant being woken up is the worst thing' -experiences of sleep in fibromyalgia syndrome. Disability and Rehabilitation 32(23):1939-1947 'This constant being woken up is the worst thing' -experiences of sleep in fibromyalgia syndrome Alice Theadom and Mark Cropley Abstract Purpose. Sleep disturbance affects a high proportion of people with fibromyalgia syndrome (FMS). This study aims to explore people's perceptions of their sleep quality and the influence sleep has on their symptoms and daily lives.Method. Semi-structured interviews were conducted with sixteen participants diagnosed with primary FMS, covering all aspects of the sleep experience. The audio recorded qualitative interviews were transcribed verbatim and analysed using interpretative phenomenological analysis.Results. Poor sleep dominated participants' lives, affecting levels of pain and fatigue, engagement in daily activities and ability to cope. Participants reported experiencing blocks of sleep, with the most profound difficulty for participants being able to go back to sleep after a night time awakening. They also felt a lack of control in their ability to manage their sleep difficulties and use of day-time napping appeared to be the only perceived beneficial coping strategy for relieving daytime sleepiness and symptoms of fatigue.Conclusions. Greater emphasis on screening for sleep disorders and how to manage poor sleep is needed in rehabilitation programmes provided for patients with FMS.

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Section: Introductionmentioning

confidence: 99%

‘This constant being woken up is the worst thing’ – experiences of sleep in fibromyalgia syndrome

Theadom

Cropley

2010

Disability and Rehabilitation

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“…L'amitriptyline (10 à 25 mg par jour) a démontré son efficacité sur la qualité du sommeil et le score de douleur de fibromyalgiques, alors que la fatigue répondrait mieux à la cyclobenzaprine (10 à 30 mg) présentant un effet myorelaxant plus marqué [13,45]. L'effet antalgique des antidépresseurs ne serait pas lié à la propre action antidépressive, aucune différence d'efficacité n'étant relevée entre patients déprimés ou non [60].…”

Section: Matériel Et Méthodesunclassified

Intérêts du réentraînement à l'effort dans la fibromyalgie et autres syndromes apparentés

Maquet

Demoulin

Croisier

et al. 2007

Annales de Réadaptation et de Médecine Physique

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RésuméObjectif. -Rédiger un article de synthèse relatif au réentraînement à l'effort dans le cadre de la fibromyalgie et d'autres syndromes apparentés. Matériel et méthodes. -La recherche bibliographique aborde (à partir de Medline via Ovid ® et PubMed ® ) les mots clés suivants : fibromyalgia; chronic fatigue syndrome; therapy; rehabilitation; aerobic; exercise; cognitive behavioral therapy. Une analyse de proche en proche est alors réalisée à partir des citations répertoriées.Résultats. -De nombreux travaux ont évalué l'intérêt du réentraînement musculaire progressif dans le cadre de la prise en charge thérapeu-tique de la fibromyalgie ou d'autres syndromes apparentés. Bien que certaines revues systématiques n'aient pu établir sans équivoque l'efficacité de cette thérapeutique, la grande majorité des auteurs relatent les bénéfices apportés par ce réentraînement musculaire chez les patients souffrant de douleurs et/ou de fatigue chronique. Ce programme de réentraînement devra idéalement être proposé dans le cadre d'une approche thérapeu-tique multidisciplinaire. Le réentraînement musculaire tentera de lutter contre le déconditionnement classiquement mis en évidence chez les fibromyalgiques et visera dès lors à enrayer le cercle vicieux associant douleur, conduite d'évitement et d'inactivité, voire de kinésiophobie, déconditionnement, incapacité et détresse psychologique.Conclusion. -Cette mise au point appuie l'intérêt d'un réentraînement musculaire progressif dans le traitement de la fibromyalgie et des syndromes associés. La mise en place de centres de revalidation, composés de praticiens capables d'apporter d'utiles réponses thérapeutiques à ces patients souffrant de douleurs et/ou de fatigue chronique, devrait aider à la prise en charge de ce problème de santé publique.

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“…Kontrollierte Studien zur Behandlung des FM-Schmerzes mit NSA erbrachten keine signifikanten Resultate, zur Wirksamkeit von Muskelrelaxanzien und lokalen Maßnahmen fehlen solche Untersuchungen 1,7].…”

Section: Medikamentöse Interventionenunclassified

Was gibt es Neues in der Therapie der Fibromyalgie?

Späth

2003

Der Schmerz

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Modern management of fibromyalgia (FM) requires a holistic approach, which includes nonpharmacologic strategies (both exercise and behavioral strategies) and pharmacologic treatment. Despite only partial effects in some patients, tricyclic antidepressants, selective serotonin reuptake inhibitors, nonsteroidal antiinflammatory drugs, analgesics and opioids are in use. The use of antiepileptic drugs and antispasticity agents is mainly supported by anecdotal data. Three other classes of agents are currently thought to have useful potentials. N-methyl-D-aspartate-(NMDA-)mediated neurotransmission may play an important role in mediating wind-up and related phenomena in pain pathways. Recent studies have demonstrated that NMDA receptor antagonists improve pain symptoms in FM. But a poor side effect profile represents a significant problem. Cerebrospinal fluid substance P concentrations are significantly elevated in FM patients, but the analgesic potential of neurokinin-1 (NK1) receptor antagonists did not meet early expectations. Tropisetron, a 5-HT3 receptor antagonist, was tested in a multicenter, double-blind, randomized, placebo-controlled trial including 403 patients. In those receiving 5 mg tropisetron, 39.2% fulfilled the response criterion (pain reduction 35%) as compared to 26.2% in the placebo group (p=0.033). On 10 and 15 mg, the responder rates were smaller and statistically not significant. A total of 78 responders to therapy were followed up for 12 months. After the end of treatment, pain intensity rose within one month in all 4 groups. Patients having received 5 or 10 mg showed a less pronounced increase in pain. In addition, even 12 months after stopping treatment, pain was still markedly below baseline levels in the 5 and 10 mg groups.

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Present state of medication therapy in fibromyalgia syndrome

Cited by 43 publications

References 25 publications

‘This constant being woken up is the worst thing’ – experiences of sleep in fibromyalgia syndrome

‘This constant being woken up is the worst thing’ – experiences of sleep in fibromyalgia syndrome

Intérêts du réentraînement à l'effort dans la fibromyalgie et autres syndromes apparentés

Was gibt es Neues in der Therapie der Fibromyalgie?

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