The relationship between fibromyalgia and major depressive disorder: A comprehensive review – Source: Current Medical Research and Opinion, July 2008

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[Note: This international team’s review of the current science comparing and contrasting FM and MDD is available free online. It includes 144 footnotes, tables laying out biological test results for the two conditions, a listing of depression drug results in FM trials, and much more.]

Objective: A large body of evidence suggests that the relationship between major depressive disorder (MDD) and fibromyalgia (FM) is complex. Improved understanding of this relationship promises to provide clinicians with better assessment and treatment options for both disorders.

Method: This paper reviews research on the prevalence, etiology and pathogenesis, clinical characterization, and treatment of FM and MDD, as well as studies that examined the relationship between these disorders. Studies were identified via PubMed literature search.


  • Our findings point to substantial similarities in neuroendocrine abnormalities, psychological characteristics, physical symptoms and treatments between FM and MDD.
  • However, currently available findings do not support the assumption that MDD and FM refer to the same underlying construct or can be seen as subsidiaries of one disease concept.


  • New methodological and theoretical approaches may lead to a better understanding of the link between FM and MDD, and to more effective psychological and psychopharmacological therapies for FM patients.
  • In the meantime, clinicians should carefully screen for a history of MDD in patients with FM.

Source: Current Medical Research and Opinion, Jul 4, 2008. 24(8) 2359-2371. PMID: 18606054, by Pae CU, Luyten P, Marks DM, Han C, Park SH, Patkar AA, Masand PS, Van Houdenhove B. Catholic University of Korea College of Medicine, Seoul, South Korea; Duke University Medical Center, Durham, North Carolina, USA; University of Leuven and University Hospitals, Leuven, Belgium. [E-mail: Chi-Un Pae]

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2 thoughts on “The relationship between fibromyalgia and major depressive disorder: A comprehensive review – Source: Current Medical Research and Opinion, July 2008”

  1. judimld says:

    Before I finally got diagnosed with CFS/FM/MCI I was told that I was depressed, even though I kept insisting I was not depressed and many times it was written on my files “denies being depressed” and “a pleasant lady”

    When I had a psychotic reaction that lasted a day or so, when I was on Prozac 10mg. and Trinalin for an upper respiratory infection, I was diagnosed with Bipolar disorder, and from there I spent three years in a psychiatric trap, taking psychotropic medications that reduced me to a very sick person, losing all muscular strength, moderate to severe memory loss, and abnormal eegs, not to mention thyroid shutdown and the inability to be gainfully employed, due to severe fatigue.
    For the first time in my life at fifty years of age, I was debilitated,not to mention 6 hospital admissions, mainly due to drug reactions and emotional stress that were diagnosed as psychiatric episodes from Bipolar Disorder.

    This also was diagnosed as the depressive stage of Bipolar Disorder, and I was not taken seriously until I nearly died with congestive heart failure.

    By this time I was having so much difficulty breathing, I could not lie flat or have any blankets on me. My ankles were swollen to my knees as I was highly sensitive to lithium, but nobody would believe me and attributed all my symptoms to depression.

    It has been ten years now since I was diagnosed with FM/CFS/MCI. I have had not one bout of depression, nor mania, but still carry the moniker of mental illness, which I cannot escape from.

    I have had no connection with psychiatry for eight years, even though it was a stipulation for me to attend a psychiatrist to collect diagbility payments. I challenged that and have not lost my benefits.

    I have a wonderful female general practitioner who refers me to specialists when the need arises. The only medication I take is Synthroid.

    I pace myself, live a very healthy lifestyle and have regained my muscular strength to the point that I am back where I was in 1995, but thirteen years older coping with the symptoms of CFS/FM/MCI.

    I am the director for the Atlantic provinces for the ME/FM Action Network and would like to have this story told.

    There is a difference between major Depresssive illness, Bipolar disorder and FM/CFS/MCI. When a person states they do not feel sad, not suicidal, not negative, not moody, knows when they are feeling “strange” while taking drugs that are known to cause psychosis, they should be believed and their symptoms investigated further. it would have saved me a great deal of grief over the past thirteen years.

    Judith Day
    Atlantic and Territories Director
    ME/FM Action Network

    1. justplainsandi says:

      judith, you have both my sympathy and my congratulations. you were in a trap that was not of your making and you not only got yourself out, you’re using the experience wisely and well.

      i had my own version of this story way back in the 60s. i was legitimately sad. i was also at what dr. pellegrino might call the prodromal stage of fibromyalgia. my doctor didn’t think i should be sad and started giving me psychoactive drugs. i think that these drugs pushed me into the next stages of fibromyalgia.

      my body doesn’t handle drugs, any drugs, well. whenever i complained about how they made me feel, which were known side effects, he added another drug, which made me feel even worse. but i was trusting and obedient and took my medicine.

      long story short, eventually i broke completely and was court committed for psychiatric observation. the doctors didn’t know what to do with me until one decided to experiment with taking me off all of the medication. that was when i started getting better. i later learned that i am allergic to a whole class of the drugs i was given.

      i’ve been very cautious about doctors and drugs ever since, even though every once in a while i still have to “pay my dues” to get past a credibility gap and into a program i need. so far i’ve been right and the doctor wrong every time. also so far, only 2 doctors have gone far enough to help me find something that will work.

      good luck with your action network. i will share your story.


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