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Fibromyalgia Syndrome’s New Paradigm: Neural Sensitization and Its Implications for Treatment

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Objectives: To provide Fibromyalgia syndrome [FMS] specialists with an overview of information suitable for the education of primary care physicians about current understanding of the mechanism of and treatments for FMS.

Findings: Controlled studies using functional magnetic resonance imaging and other objective markers document FMS as a disorder of increased sensitivity of the central nervous system’s pain signaling pathways. This “neural sensitization” model shifts the focus for treatment toward drugs that affect neural pathways.

New options include:


  • 5-hydroxytryptamine serotonin receptor antagonists such as odansetron [Zofran],

  • N-methyl-D-aspartate receptor antagonists such as Ketamine,

  • Growth hormone stimulants such as pyridostigmine [Mestinon],

  • Anti-seizure drugs such as gapapentin [Neurontin] or pregabalin [Lyrica],

  • Gamma hydroxy butyrate-related agonists such as sodium sodium oxybate [Xyrem],

  • And the new serotonin-norepinephrine reuptake inhibitors-class antidepressants such as duloxetine [Cymbalta] and milnacipran.

Also recommended is appropriately graded exercise, i.e., conditioning, work on sleep quality, and cognitive behavioral therapy to support coping skills.

Conclusion: Improved understanding of the neural mechanisms involved in FMS and new options for treatment make it imperative that FMS specialists reach out to educate their primary care physician colleagues.

Source: Journal of Musculoskeletal Pain, Volume: 15 Issue: 2, Page Range: 45 – 54 , DOI: 10.1300/J094v15n02_08, by Podell RN. UMDNJ-Robert Wood Johnson Medical School.

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3 thoughts on “Fibromyalgia Syndrome’s New Paradigm: Neural Sensitization and Its Implications for Treatment”

  1. bearcat says:

    Finally we are getting some substantive research that demonstrates the true source of our pain! Although not delineating the etiology it nevertheless serves to validate our pain. I am on three of the newly advised medications (gabapentin,xyrem and cymbalta) and although not cured am so very much better. I am increasingly hopeful as I see research move away from female hysteria approaches to looking at what’s going on in our neural systems and brains.

    1. angelstapleton says:

      I was glad to hear your doing good.
      I been sick for about 2 years and have just started to see new Dr. I am hoping to find one that will get me on the right track to aleast feeling better 50% of the time. I live in Mount vernon Mo . So if you know of any please let me know.
      Thanks Bless you you for your info .
      Angel

    2. applepansy says:

      what side effects are you dealing with?

      thanks

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