The location of the 19 pain areas for the Widespread Pain Index of fibromyalgia
Duloxetine, an example of an SNRI.
Timeline of approved SNRIs.
A woman feeling stress
Timeline of development of antidepressant agents.
The location of the nine paired tender points that comprise the 1990 American College of Rheumatology criteria for fibromyalgia
Inhibiting the reuptake transport protein results in increased concentrations of serotonin and norepinephrine in the synaptic clefts, leading to improvement of depression symptoms.
Widespread pain index (WPI) areas
Aryloxypropanamine scaffold and agents containing it.
Stress and trauma are strongly linked to fibromyalgia
Cycloalkanol ethylamine scaffold and agents containing it.
Structure of milnacipran.

Serotonin–norepinephrine reuptake inhibitors (SNRIs) are a class of antidepressant drugs used to treat major depressive disorder (MDD), anxiety disorders, obsessive–compulsive disorder (OCD), social phobia, attention-deficit hyperactivity disorder (ADHD), chronic neuropathic pain, fibromyalgia syndrome (FMS), and menopausal symptoms.

- Serotonin–norepinephrine reuptake inhibitor

Other common helpful medications include serotonin-noradrenaline reuptake inhibitors (SNRI), non-steroidal anti-inflammatory drugs (NSAIDs), and muscle relaxants.

- Fibromyalgia
The location of the 19 pain areas for the Widespread Pain Index of fibromyalgia

6 related topics with Alpha

Overall

Gate control theory of pain

Neuropathic pain

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Pain caused by damage or disease affecting the somatosensory system.

Pain caused by damage or disease affecting the somatosensory system.

Gate control theory of pain
Microglia (identified by alpha-coronin1a), and neurons in culture. Microglia are proposed to release molecules that alter the excitability of neurons.

First line treatments are certain antidepressants (tricyclic antidepressants and serotonin–norepinephrine reuptake inhibitors), anticonvulsants (pregabalin and gabapentin).

Gabapentin may reduce symptoms associated with neuropathic pain or fibromyalgia in some people.

Chemical structure of the prototypical and first marketed tricyclic antidepressant imipramine. Notice its three rings.

Tricyclic antidepressant

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Important for the management of depression.

Important for the management of depression.

Chemical structure of the prototypical and first marketed tricyclic antidepressant imipramine. Notice its three rings.
Chemical structure of the prototypical and first marketed tricyclic antidepressant imipramine. Notice its three rings.

Although TCAs are sometimes prescribed for depressive disorders, they have been largely replaced in clinical use in most parts of the world by newer antidepressants such as selective serotonin reuptake inhibitors (SSRIs), serotonin–norepinephrine reuptake inhibitors (SNRIs) and norepinephrine reuptake inhibitors (NRIs).

They are also used in the treatment of a number of other medical disorders, including cyclic vomiting syndrome (CVS) and anxiety disorders such as generalized anxiety disorder (GAD), social phobia (SP) also known as social anxiety disorder (SAD), obsessive-compulsive disorder (OCD), and panic disorder (PD), post-traumatic stress disorder (PTSD), body dysmorphic disorder (BDD), eating disorders like anorexia nervosa and bulimia nervosa, certain personality disorders such as borderline personality disorder (BPD), neurological disorders such as attention-deficit hyperactivity disorder (ADHD), Parkinson's disease as well as chronic pain, neuralgia or neuropathic pain, and fibromyalgia, headache, or migraine, smoking cessation, tourette syndrome, trichotillomania, irritable bowel syndrome (IBS), interstitial cystitis (IC), nocturnal enuresis (NE), narcolepsy, insomnia, pathological crying and/or laughing, chronic hiccups, ciguatera poisoning, and as an adjunct in schizophrenia.

The skeleton structure of the SNRI venlafaxine, a typical example of an antidepressant.

Antidepressant

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Antidepressants are medications used to treat major depressive disorder, some anxiety disorders, some chronic pain conditions, and to help manage some addictions.

Antidepressants are medications used to treat major depressive disorder, some anxiety disorders, some chronic pain conditions, and to help manage some addictions.

The skeleton structure of the SNRI venlafaxine, a typical example of an antidepressant.
The skeleton structure of the SNRI venlafaxine, a typical example of an antidepressant.
Blister pack of Prozac (fluoxetine), a selective serotonin reuptake inhibitor
The chemical structure of venlafaxine (Effexor), an SNRI
St John's wort
Structural formula of the SSRI sertraline

A 2012 meta-analysis concluded that antidepressants treatment favorably affects pain, health-related quality of life, depression, and sleep in fibromyalgia syndrome.

A discontinuation syndrome can occur after stopping any antidepressant including selective serotonin re-uptake inhibitors (SSRIs), serotonin–norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs).

Cymbalta (duloxetine) 60mg

Duloxetine

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Cymbalta (duloxetine) 60mg

Duloxetine, sold under the brand name Cymbalta among others, is a medication used to treat major depressive disorder, generalized anxiety disorder, fibromyalgia, neuropathic pain and central sensitization.

It is a serotonin–norepinephrine reuptake inhibitor.

Milnacipran

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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.

Generic tramadol HCl tablets marketed by Amneal Pharmaceuticals

Tramadol

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Opioid pain medication used to treat moderate to moderately severe pain.

Opioid pain medication used to treat moderate to moderately severe pain.

Generic tramadol HCl tablets marketed by Amneal Pharmaceuticals
Tramadol HCl for injection
Foil pack of 10 Utracet tablets
Main side effects of tramadol: Red color denotes more serious effects, requiring immediate contact with health provider.
Desmetramadol.

Tramadol is also a serotonin–norepinephrine reuptake inhibitor (SNRI).

There is moderate evidence for use as a second-line treatment for fibromyalgia but it is not FDA approved for this use; however, its use is approved for treatment of fibromyalgia as a secondary painkiller by the NHS.