Pharmacological treatment of fibromyalgia

Fibromyalgia (FM) is a complex and little known disease, health professionals face a pathology with a difficult diagnosis, without a therapeutic target, which causes a high burden of morbidity and costs.1–4 There is no single treatment that has proven effective. Several attempts have been made to elucidate the best ways to diagnose and treat FM, but so far no objective evidence has been found to allow the diagnosis to be made or ruled out.1,5–7 Functional magnetic resonance imaging and biochemical marker tests are not useful because they indicate the existence of pain, but not its cause.8,9 This leads to the diagnosis being controversial because it is based only on subjective criteria, which can cause a misdiagnosis of the disease, since each doctor can give a different interpretation has shown that not all doctors know the criteria from the American College of Rheumatology (ACR) to establish a diagnosis.10–12 This is sometimes because many doctors do not accept FM as a pathology, and consider it as a poor adaptive response to stress or depression, increasing patient frustration and generating poor adherence to medical management, which leads to rupture of the doctor-patient relationship. One of the contradictors of the FM is Dr. Frederick Wolfe, director of the National Data Bank for Rheumatic Diseases and lead author of the 1990 article that first defined the diagnostic guidelines for FM, who considers that it is not a disease if not a physical response to stress, depression and economic and social anxiety. Wolfe said that “some of us in those days thought that we had actually identified a disease, which clearly is not,” “Making people sick, making them sick, was something wrong.” Therefore, FM is considered not It requires no pharmacological treatment and that this has only been driven by the profits produced by the sale and commercialization of some medications as without being clear about how it reduces pain.5,11