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The drug is used to treat acute and chronic pain. It has shown effectiveness in the treatment of fibromyalgia, though it is not specifically approved for this purpose. The drug is also under investigation as an antidepressant and for the treatment of neuropathic pain. It is related in chemical structure to venlafaxine.
Tramadol is used primarily to treat mild to severe pain, both acute and chronic. [23] [24] There is moderate evidence for use as a second-line treatment for fibromyalgia, but it is not FDA-approved for this use. [25] Its use is approved for treatment of fibromyalgia as a secondary painkiller by the NHS. [26]
The use of medication in the treatment of fibromyalgia is debated, [18] [19] although antidepressants can improve quality of life. [20] Other medications commonly considered helpful in managing fibromyalgia include serotonin–norepinephrine reuptake inhibitors, nonsteroidal anti-inflammatory drugs, and muscle relaxants. [21]
A 2004 review found benefit for fibromyalgia symptoms, with a reported number needed to treat of 4.8 (meaning that 1 person out of every 4.8 benefits from treatment) for pain reduction, but no change in fatigue or tender points. [36] A 2009 Cochrane review found insufficient evidence to justify its use in myofascial pain syndrome. [37]
Guaifenesin. Guaifenesin protocol is an unapproved treatment for fibromyalgia suggested in the 1990s by R. Paul St. Amand, M.D.The protocol involves three parts: titrating the guaifenesin dosage, avoiding salicylates, and following a low-carbohydrate diet if the patient is hypoglycemic.
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.