Fibromyalgia treatment with pregabalin plus duloxetine
Fibromyalgia is generally characterized by chronic pain which is widespread and also associated with sleep disturbances, depression, fatigue and cognitive dysfunction. People with fibromyalgia are usually treated with pain medicines, antidepressants, muscle relaxants, and sleep medicines. Polypharmacy is commonly used, but studies which can support the evidence is limited. Various trials have been conducted, with majority focused primarily on pain reduction with monotherapy. Similarly, another trial was conducted with a combination of pregabalin and duloxetine.
A study with participants who received maximally tolerated doses of placebo, pregabalin, duloxetine and pregabalin-duloxetine for almost 6 weeks was conducted. As a result, primary outcome was daily pain and secondary outcomes was global pain relief.
Results indicated that daily pain during placebo, pregabalin, duloxetine and combination was 5.1, 5.0, 4.1, and 3.7, respectively. However, participants reported that there were moderate global pain relief of 18%, 39%, 42% and 68% respectively. Fibromyalgia Impact Questionnaire scores observed were 42.9, 37.4, 36.0, and 29.8, respectively. SF-36 scores were 50.2, 55.7, 56.0, and 61.2, respectively. Medical Outcomes Study Sleep Scale scores were 48.9, 35.2, 46.1, and 32.1, respectively. BDI-II scores were 11.9, 9.9, 10.7, and 8.9, respectively.
On trial completion, it was concluded that moderate to severe drowsiness was more frequent in patients during comparison between combination vs placebo. It was stated that combining pregabalin and duloxetine prescribed for fibromyalgia improved the multiple clinical outcomes vs monotherapy. It was suggested that continued research should compare the prescribed combination or other combination to monotherapy for fibromyalgia.