A recent review found that, for most fibromyalgia patients, two commonly prescribed medications either didn’t provide relief or were stopped due to side effects. The authors suggest patients should look beyond drugs to other treatment options, like exercise and therapy, for better relief of the widespread pain, fatigue and sleep problems that are hallmarks of the condition.

“The effects of drugs – on average – are poor compared to placebo on fibromyalgia symptoms,” explains lead author Winfried Häuser, MD, associate professor of psychosomatic medicine and pschyotherapy at Technische Universität München in Germany.

Dr. Häuser led the new review, published online recently in The Cochrane Library, which looked at 10 studies involving more than 6,000 patients given a placebo and either duloxetine (Cymbalta) or milnacipran (Savella) for anywhere from 12 to 27 weeks. Patients were typically between the ages of 47 and 51 and most were women – a reflection of the fact that between 80 and 90 percent of the estimated five million Americans with fibromyalgia are women.

Researchers say after an average of 18 weeks, “the drugs had a small, incremental effect over placebo in reducing pain” with 29 percent of patients taking one of the medications reporting at least a 50 percent pain reduction compared to 19 percent taking placebo. The medications did not “reduce fatigue substantially (2.5 percent relative improvement) … and did not improve [quality of life] substantially (4.6 percent relative improvement) … compared to placebo.” There was no difference in improvement of sleep problems between the drug and placebo group.

But 20 percent taking the drugs and 11 percent on placebo stopped the medications because of side effects, such as nausea, headache and constipation – a statistically significant difference. Serious problems like liver damage and abnormal bleeding were rare, with no statistically significant difference between those taking the active drug and those taking placebo.