Review of pharmacological therapies in fibromyalgia syndrome

Table 1 Thirty percent pain reduction rates in randomized controlled trials with antidepressants and pregabalin in patients with fibromyalgia syndrome

Drug (reference)	Number of RCTs/participants	30% pain reduction true drug vs. placebo (%)	RR 30% pain reduction (95% CI)	Dropout rate due to adverse events, percentage	RR dropout rate due to adverse events (95% CI)
Duloxetine^a[17]	5/1,884	46.8 vs. 34.0	1.33 (1.18-1.51)	18.7 vs.10.4	1.65 (1.30-2.09)
Milnacipran^b[17]	5/4,110	36.4 vs. 28.1	1.38 (1.25-1.51)	21.5 vs.11.0	2.00 (1.47-2.73)
SSRIs^c[20]	7/414	36.4 vs. 20.6	1.59 (1.01-2.52)	9.5 vs. 7.0	1.60 (0.84-3.04)
TCAs^d[20]	9/542	48.3 vs. 27.8	1.60 (1.15-2.34)	5.2 vs. 6.5	0.84 (0.46-1.52)
Pregabalin^e[22]	5/3,259	40.0 vs. 29.1	1.37 (1.22-1.53)	19.4 vs. 11.0	1.68 (1.36-2.07)

^aDosages 60 mg/day, 120 mg/day, and 60 to 120 mg/day flexible pooled together. ^bDosages 100 mg/day, 200 mg/day, and 100 to 200 mg/day flexible pooled together. ^cCitalopram 20–40 mg/day, Fluoxetine 12–80 mg/day, Paroxetine 20–60 mg/day. ^dAmitriptyline 10–50 mg/day. ^eDosages 150 mg/day, 300 mg/day, 450 mg/day, 600 mg/d, and 300–450 mg/day flexible pooled together. One study with 556 participants and an enriched enrolment withdrawal design could not be included in meta-analysis. CI, confidence interval; RCT, randomized controlled trial; RR, relative risk; SSRI, selective serotonin reuptake inhibitor; TCA, tricyclic antidepressant.

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