Study Shows Fibromyalgia Patients Find Combination Therapy a More Effective Pain Treatment

Study Shows Fibromyalgia Patients Find Combination Therapy a More Effective Pain Treatment

Canada’s Queen’s University scientist Ian Gilron has found a more effective way to treat fibromyalgia by combining Lyrica (pregabalin), an anticonvulsant drug, with Cymbalta (duloxetine), an antidepressant.

The study, “Combination of pregabalin with duloxetine for fibromyalgia: a randomized controlled trial,” was published in the journal Pain.

The results demonstrated that the combination of the two drugs can safely improve outcomes in fibromyalgia, including not only pain relief but also physical function and overall quality of life.

“Previous evidence supports added benefits with some drug combinations in fibromyalgia,” Gilron said in a news release. “We are very excited to present the first evidence demonstrating superiority of a duloxetine-pregabalin combination over either drug alone.”

Fibromyalgia is a clinical syndrome characterized by chronic widespread pain. Symptoms include sleep disturbance, depression, fatigue, and cognitive dysfunction.

“The condition affects about 1.5 to 5 percent of Canadians — more than twice as many women as men. It can have a devastating on the lives of patients and their families,” Gilron said. “Current treatments for fibromyalgia are either ineffective or intolerable for many patients.”

Evidence supports a diverse array of treatments for fibromyalgia including exercise, pharmacological, physical, psychological, and other therapies. The anticonvulsant Lyrica and the antidepressant Cymbalta are two newer pharmacological therapies that are widely used to treat fibromyalgia. Lyrica and Cymbalta are thought to reduce pain by different pharmacological actions, thereby providing a mechanistic rationale for combining the two.

The new study compared a Lyrica-Cymbalta combination to each drug individually. Using a randomized, double-blind, four-period crossover design, 39 patients completed a treatment with maximally tolerated doses of a placebo; Lyrica alone; Cymbalta alone; and a Lyrica-Cymbalta combination, over a period of six weeks.

The trial’s primary endpoint was daily pain, and secondary outcomes included global pain relief, Fibromyalgia Impact Questionnaire, SF-36 survey, Medical Outcomes Study Sleep Scale, Beck Depression Inventory (BDI-II), adverse events, and other measures.

The results suggested that combining Lyrica with Cymbalta can safely improve outcomes in fibromyalgia, including pain relief, physical function, and overall quality of life.

By identifying and studying promising drug combinations, research is showing how physicians can make the best use of current treatments available to patients. “The value of such combination approaches is they typically involve drugs that have been extensively studied and are well known to healthcare providers,” Gilron said.

6 comments

  1. Bonnie Watson says:

    I started with Gabapentin only then after several months Cymbalta was added. Not seeing much relief and it’s been quite awhile. Is Lryica in the same field as Gabapentin? I have appt. w/reg. Dr. and rhumetologist this month and would like to talk to them about this study. I don’t believe either of them (or for that matter most Dr.s) follow the studies that I see. TIA for any input on your results.

  2. Kelly says:

    I have been on both Cymbalta & Lyrica, as well as Tridural (Tramadol) and none of the helped. I have also had nerve block therapy, that is, analgesics injected directly into the nerve. The Medical Marijuana therapy I am now undergoing has given me the best results and most relief, out of all other medications I have taken for my Fibro over the past 19+years

    • Erma says:

      I also have started on medical marijuana and is the only thing that gives me energy and takes a lot of my pain. My sister who doesn’t have fibromyalgia told me… “Well, that’s what you say” well it does… And I pray that she will never experience the pain I feel.

  3. julie spear says:

    I currently take gabapentin 2 3xdaily but all they seem to do is relax me & make me sleepy, I was diagnosed with fibromyalgia in march, I also take sertraline for depression/anxiety which I’ve been taking for 3yrs but don’t think they work now! I take one antihistamine daily all year round for allergy’s am allergic to all types of fur/feathers animals in gen & pollen. I take omeprazole if I have to take ibuprofen for extra pain relief & take paracetamol on a daily basis wouldn’t be without them. After a burst of energy yesterday I’m really tired today. I’m lucky if I have 2-3 days out of a week when I am active. I also have gained even more weight & swear that’s down to the gabapentin? Help I need answers to what the best step forward is to take, without my Dr fobbing me off with other meds that may or may not work?

  4. Michelle says:

    Lyrica and Cymbalta both cause weight gain, this doesn’t help with the pain the extra weight causes. They also both effective your sexual drive. So if you already have depression anxiety the weight gain and loss of desire to be with your partner or spouse will definitely make them worse. The side effects outweigh the minimal pain reduction. Neither take the pain away completely unless you are fortunate to have a physician who also prescribes a good pain medication.

  5. Denise says:

    My husband had been on Cymbalta for a year with terrible morning sickness lasting half a day. His rheumatologist then added Gabapentin along with the Cymbalta and he has felt the best he has in two years for the past few months. He also uses medical marijuana for pain. He is underweight, so any weight gain is appreciated. He is up a few pounds but must watch that he eats enough so that he doesn’t go back down. He finally feels like getting back to working out a bit like he used to. He was quite athletic prior to diagnosis of a fibromyalgia-type condition that could never be confirmed with blood tests.

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