Treatment of Fibromyalgia - duloxetine or pregabalin?

Introduction: Fibromyalgia (FM) is a complex and chronic condition characterized by widespread pain, fatigue, and disrupted sleep, often accompanied by mood disturbances and cognitive difficulties. The pathophysiology of FM involves heightened pain sensitivity, altered neurotransmitter levels, and neurochemical imbalances, including elevated substance P and glutamate. Duloxetine, a serotonin-norepinephrine reuptake inhibitor (SNRI), has demonstrated efficacy in managing FM symptoms, particularly pain, functional impairment, and quality of life. Pregabalin, another widely used FM medication, reduces pain by modulating calcium channels and neurotransmitter release, improving sleep and reducing fatigue. Comparative studies indicate that duloxetine may offer broader benefits, including reduced healthcare utilization, due to its dual role in pain relief and mood stabilization. While pregabalin may be preferred in patients with specific comorbidities like functional dyspepsia, duloxetine’s antidepressant effects make it a compelling option for individuals with depression-related FM symptoms. Aim of the study: The study aimed to analyze the current treatment of Fibromyalgia and compare two main treatment methods, duloxetine and pregabalin. Review method: The following keywords, such as fibromyalgia treatment, duloxetine, and pregabalin, have been included in the search phrases used to thoroughly examine research publications available on Pubmed. Conclusion: This review highlights the importance of personalized treatment strategies for FM, integrating pharmacological and non-pharmacological approaches within a biopsychosocial framework. By tailoring therapies to individual needs, clinicians can optimize outcomes and improve patient quality of life.