From: Beyond pain in fibromyalgia: insights into the symptom of fatigue
Intervention | Design and sample | Scales used | Mechanism of action | Effect on fatigue |
---|---|---|---|---|
Duloxetine | 3 double blind, placebo-controlled RCTs of patients with FM (n = 899) [88–90] | MFI | Blocks reuptake of serotonin and norepinephrine within the central nervous system | Clinically meaningful improvement in 2 of the RCTs, no clinically meaningful improvement in the other |
FIQ fatigue | ||||
Milnacipran | 6 double-blind, placebo-controlled RCTs of patients with FM (n = 4,243) [91–96] | MFI | Blocks reuptake of serotonin and norepinephrine within the central nervous system | No clinically meaningful improvement in 4 RCTs using MFI, cannot draw conclusion in 2 RCTs, and clinically meaningful improvement in 1 RCT (VAS fatigue) |
1 double-blind, dose finding trial (n = 468) [97] | VAS fatigue | |||
Pregabalin | 3 double-blind, placebo-controlled RCTs of patients with FM (n = 2,328) [98–100] | MAF | Interacts with the alpha-2-delta subunit of l-type voltage-regulated calcium channels | No clinically meaningful improvement in 2 RCTs, cannot draw conclusion in 1 RCT |