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Fibromyalgia: 30 years of drug-seeking behavior

Nature Clinical Practice Rheumatology volume 3, pages 62–63 (2007)Cite this article

'Fibromyalgia' is a controversial diagnostic term that comprises many symptoms, including diffuse pain, fatigue, numbness, stiffness, cognitive symptoms, depression, and anxiety. Whether fibromyalgia is primarily a somatoform disorder or results from abnormal neurotransmission is still a subject for vigorous debate.1 Patients with fibromyalgia have been described as “living under a pall”,2 hence antidepressants are frequently prescribed; however, they have done little to stem the tide of this increasingly discussed and problematic illness. Patients and physicians therefore continue to seek alternative treatments.

Anything that alleviates the misery that patients with fibromyalgia suffer from has to be a good thing, even if it involves medication. From the early studies of antidepressants3 to the recently published studies,4 it has become clear that some patients with fibromyalgia can benefit from prescribed medication. These recent findings mirror the trend that has seen patients and physicians alike seeking a chemical solution to the problem of fibromyalgia for more than 30 years. Indeed, the routine physician response to the fibromyalgia patient can most readily be symbolized by the prescription pad. That a patient with fibromyalgia could visit the clinic for treatment and end up with no drug being prescribed was, until recently, almost unimaginable. For most patients, a prescription symbolizes, in part, a medical imprimatur that they have a 'disease' and are, therefore, being taken seriously. Fibromyalgia patients struggle with a disorder lacking sufficient means for validation, and drug prescriptions offer this validation. For clinicians, drugs are easier both to prescribe and to justify to the patient, compared with prescribing exercise-based therapy or cognitive-behavioral therapy, which most commonly will follow a necessarily prolonged discussion of the common prevalence of chronic pain in the normal population. The problem of fibromyalgia is thus medicalized.

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Authors and Affiliations

  1. RR Ferrari is a Clinical Professor of Medicine in the Department of Medicine and AS Russell is a Professor of Medicine in the Department of Rheumatic Diseases at the University of Alberta, Edmonton, Alberta, Canada.,

    Robert R Ferrari & Anthony S Russell

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  1. Robert R Ferrari
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  2. Anthony S Russell
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Correspondence to Anthony S Russell.

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The authors declare no competing financial interests.

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Ferrari, R., Russell, A. Fibromyalgia: 30 years of drug-seeking behavior. Nat Rev Rheumatol 3, 62–63 (2007). https://doi.org/10.1038/ncprheum0408

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