There is insufficient evidence to prove whether multiple or single therapies are the best way to treat fibromyalgia, a study reports.
The review, “Combination pharmacotherapy for the treatment of fibromyalgia in adults,” was published in the journal Cochrane Database of Systematic Reviews.
People with fibromyalgia experience chronic pain, sleep problems, and fatigue. Common pain medications such as paracetamol (acetaminophen) and ibuprofen are usually ineffective.
Treatments for epilepsy, depression, or other conditions help some fibromyalgia patients. But many patients take multiple drugs to deal with pain.
There has been no consensus on whether using a number of drugs is better than a single one for treating fibromyalgia. So a research team decided to look into the question.
They used online databases to search for double-blind, randomized, controlled clinical trials comparing combinations of two or more drugs with a placebo as a fibromyalgia treatment.
The team found 16 studies covering 1,474 people. Although the studies looked at combinations of a number of drugs, they did not provide enough evidence to draw conclusions.
Unfortunately, many of the studies did not compare a combination of drugs with each of the component therapies. Some compared the combos with only one of the medicines or a placebo. This limited researchers’ ability to make conclusions.
Three studies did generate some evidence that a combo was better than a single drug at reducing pain. These tested combinations of melatonin and Elavil (amitriptyline), Prozac (fluoxetine) and Elavil, and Lyrica (pregabalin) and Cymbalta (duloxetine).
But other studies showed that one drug was better than a combo, and some studies did not find a difference.
One conclusive finding was that neither the combos nor single drugs generated severe side effects.
“There are few large high-quality trials comparing combination pharmacotherapy with monotherapy for fibromyalgia,” the team wrote. This has limited the “evidence to support or refute the use of combination pharmacotherapy for fibromyalgia.”