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A 2014 Cochrane review concluded that duloxetine is beneficial in the treatment of diabetic neuropathy and fibromyalgia but that more comparative studies with other medicines are needed. [22] The French medical journal Prescrire concluded that duloxetine is no better than other available agents and has a greater risk of side effects. [ 23 ]
During its development for fibromyalgia, milnacipran was evaluated utilizing a composite responder approach.To be considered as a responder for the composite ‘treatment of fibromyalgia’ endpoint, each patient had to show concurrent and clinically meaningful improvements in pain, physical function, and global impression of disease status.
Amitriptyline, sold under the brand name Elavil among others, is a tricyclic antidepressant primarily used to treat major depressive disorder, and a variety of pain syndromes such as neuropathic pain, fibromyalgia, migraine and tension headaches. [12]
The use of medication in the treatment of fibromyalgia is debated, [16] [14] although antidepressants can improve quality of life. [17] Other medications commonly considered helpful in managing fibromyalgia include serotonin–norepinephrine reuptake inhibitors, nonsteroidal anti-inflammatory drugs, and muscle relaxants. [18]
A 2012 meta-analysis concluded that antidepressant treatment favorably affects pain, health-related quality of life, depression, and sleep in fibromyalgia syndrome. Tricyclics appear to be the most effective class, with moderate effects on pain and sleep, and small effects on fatigue and health-related quality of life.
Bupropion is another antidepressant used for the treatment of depression as well as seasonal affective disorder (SAD). It’s sold under the brand names: Wellbutrin. Wellbutrin SR.
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