Tratamiento farmacológico en la fibromialgia

Seminarios de la Fundación Espa?ola de Reumatología Pub Date : 2011-01-01 DOI:10.1016/j.semreu.2010.05.003

Javier Rivera Redondo

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引用次数: 6

Abstract

Some drugs have proven efficacy in controlling the clinical symptoms of fibromyalgia. The drugs with the greatest demonstrated efficacy are tricyclic antidepressants (e.g. amitriptyline or cyclobenzaprine), selective serotonin reuptake inhibitors (e.g. fluoxetine), serotonin and norepinephrine reuptake inhibitors (e.g. duloxetine and milnazipram), some analgesics such as acetaminophen, alone or in combination with tramadol, and some anticonvulsant drugs such as pregabalin.

Other drugs such as non-steroidal antiinflammatory agents, major opioids, hormonal treatments and herbal medicines have shown no efficacy in clinical trials and consequently are not recommended in the treatment of fibromyalgia.

Some antidepressants, such as venlafaxine, moclobemide, pirlindole, mirtazapine and bupropion, have shown efficacy in some studies but more clinical trials are required before they can be recommended in patients with fibromyalgia.

Dopamine agonist receptors may be a good option in the future for the treatment of fibromyalgia if preliminary clinical studies with these drugs are confirmed.

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纤维肌痛的药物治疗

一些药物已被证明对控制纤维肌痛的临床症状有效。疗效最好的药物是三环抗抑郁药(如阿米替林或环苯扎林)、选择性5 -羟色胺再摄取抑制剂(如氟西汀)、5 -羟色胺和去甲肾上腺素再摄取抑制剂(如度洛西汀和米纳齐普兰)、某些镇痛药(如对乙酰氨基酚)单独使用或与曲马多合用，以及一些抗惊厥药物，如普瑞巴林。其他药物，如非甾体抗炎药、主要阿片类药物、激素治疗和草药，在临床试验中没有显示出疗效，因此不推荐用于治疗纤维肌痛。一些抗抑郁药，如文拉法辛、莫氯比胺、吡林多、米氮平和安非他酮，在一些研究中显示出疗效，但在纤维肌痛患者推荐使用它们之前，还需要更多的临床试验。如果这些药物的初步临床研究得到证实，多巴胺激动剂受体可能是未来治疗纤维肌痛的一个很好的选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Seminarios de la Fundación Espa?ola de Reumatología

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