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Milnacipran (trade names Ixel, Savella, Dalcipran, Toledomin) is a serotonin–norepinephrine reuptake inhibitor (SNRI) used in the clinical treatment of fibromyalgia. It is not approved for the clinical treatment of major depressive disorder in the US, but it is in other countries.
The use of medication in the treatment of fibromyalgia is debated, [18] [19] although antidepressants can improve quality of life. [20] Other medications commonly considered helpful in managing fibromyalgia include serotonin–norepinephrine reuptake inhibitors , nonsteroidal anti-inflammatory drugs , and muscle relaxants . [ 21 ]
A 2004 review found benefit for fibromyalgia symptoms, with a reported number needed to treat of 4.8 (meaning that 1 person out of every 4.8 benefits from treatment) for pain reduction, but no change in fatigue or tender points. [36] A 2009 Cochrane review found insufficient evidence to justify its use in myofascial pain syndrome. [37]
Duloxetine, sold under the brand name Cymbalta among others, [1] is a medication used to treat major depressive disorder, generalized anxiety disorder, obsessive-compulsive disorder, fibromyalgia, neuropathic pain and central sensitization.
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Guaifenesin. Guaifenesin protocol is an unapproved treatment for fibromyalgia suggested in the 1990s by R. Paul St. Amand, M.D.The protocol involves three parts: titrating the guaifenesin dosage, avoiding salicylates, and following a low-carbohydrate diet if the patient is hypoglycemic.
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