Fibromyalgia future or investigational therapies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Several drugs, including milnacipran, guaifenesin, and dextromethorphan are being investigated as potential therapies for fibromyalgia. Milnacipran is a serotonin-norepinephrine reuptake inhibitor (SNRI), and a Phase III study demonstrated statistically significant therapeutic effects of the drug as a treatment for fibromyalgia syndrome. Guaifenesin is a more controversial potential therapy, and a study by researchers at Oregon Health Science University in Portland failed to demonstrate any benefits from this treatment, though results of the study have since been contested. Dextromethorphan is an over-the-counter cough medicine that has been used in research settings to investigate the nature of fibromyalgia pain, but there are no controlled trials of its safety or efficacy in clinical use.

Future or Investigational Therapies

Milnacipran, a serotonin-norepinephrine reuptake inhibitor (SNRI), is available in parts of Europe where it has been safely prescribed for other disorders. On May 22nd, 2007, a Phase III study demonstrated statistically significant therapeutic effects of milnacipran as a treatment for fibromyalgia syndrome.

Among the more controversial therapies is the use of guaifenesin. Called St. Amand's protocol or the guaifenesin protocol, the efficacy of guaifenesin in treating fibromyalgia has not been proven in properly designed research studies. Indeed, a controlled study conducted by researchers at Oregon Health Science University in Portland failed to demonstrate any benefits from this treatment, and the lead researcher has suggested that the anecdotally reported benefits were due to placebo suggestion. The results of the study have since been contested by Dr. St. Amand, who was a co-author of the original research report.[1]

Dextromethorphan is an over-the-counter cough medicine with activity as an NMDA receptor antagonist. It has been used in research settings to investigate the nature of fibromyalgia pain; however, there are no controlled trials of its safety or efficacy in clinical use.[2]

References

  1. St. Amand, R. Paul (1997). "A Response To The Oregon Study's Implication". Clinical Bulletin of Myofascial Therapy. 2 (4). Retrieved 2007-06-23.
  2. Staud R, Vierck CJ, Robinson ME, Price DD (2005). "Effects of the N-methyl-D-aspartate receptor antagonist dextromethorphan on temporal summation of pain are similar in fibromyalgia patients and normal control subjects". The journal of pain : official journal of the American Pain Society. 6 (5): 323–32. doi:10.1016/j.jpain.2005.01.357. PMID 15890634.

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