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Fibromyalgia Syndrome's New Paradigm: Neural Sensitization and Its Implications for Treatment.
- Source :
-
Journal of Musculoskeletal Pain . 2007, Vol. 15 Issue 2, p45-54. 10p. 2 Charts. - Publication Year :
- 2007
-
Abstract
- 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 [Lyrical, 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. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 10582452
- Volume :
- 15
- Issue :
- 2
- Database :
- Academic Search Index
- Journal :
- Journal of Musculoskeletal Pain
- Publication Type :
- Academic Journal
- Accession number :
- 25920783
- Full Text :
- https://doi.org/10.1300/J094v15n02_08