Fibromyalgia future or investigational therapies
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
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 of fibromyalgia syndrome. At this time, only initial top-line results are available and further analyses will be completed in the coming weeks. If ultimately approved by the FDA, Milnacipran could be distributed in the United States as early as summer, 2008.
Among the more controversial therapies involves 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 annecdotaly reported benefits where due to placebo suggestion. The results of the study have since been contested by Dr St. Amand, who was a co-author or 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 the research setting to investigate the nature of fibromyalgia pain[2]; however, there are no controlled trials of safety or efficacy in clinical use.
References
- ↑ St. Amand, R. Paul (1997). "A Response To The Oregon Study's Implication". Clinical Bulletin of Myofascial Therapy. 2 (4). Retrieved 2007-06-23.
- ↑ 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.