OBJECTIVE: To evaluate and compare the efficacy of
pharmacological and nonpharmacological treatments of
fibromyalgia syndrome (FMS).
METHODS: This meta-analysis of 49
fibromyalgia treatment outcome studies assessed the efficacy
of pharmacological and nonpharmacological treatment across
four types of outcome measures-physical status, self-report of
FMS symptoms, psychological status, and daily functioning.
RESULTS: After controlling for study design, antidepressants
resulted in improvements on physical status and self-report of
FMS symptoms. All nonpharmacological treatments were
associated with significant improvements in all four
categories of outcome measures with the exception that
physically-based treatment (primarily exercise) did not
significantly improve daily functioning. When compared,
nonpharmacological treatment appears to be more efficacious in
improving self-report of FMS symptoms than pharmacological
treatment alone. A similar trend was suggested for functional
CONCLUSION: The optimal intervention for FMS would
include nonpharmacological treatments, specifically exercise
and cognitive-behavioral therapy, in addition to appropriate
medication management as needed for sleep and pain symptoms.
Rossy LA, Buckelew SP, Dorr N, Hagglund KJ, Thayer JF, McIntosh MJ,
Hewett JE, Johnson JC