University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository


Primary Care


Dr. Laura Witte



Purpose: The purpose of this article is to compare the effectiveness of Tricyclic Antidepressants (TCAs) against Selective Norepinephrine Reuptake Inhibitors (SNRIs) in the treatment of pain and psychological symptoms associated with fibromyalgia.

Method: A PubMed literature search was conducted with search terms fibromyalgia, treatment, tricyclic, and SNRI. A search term of fibromyalgia was also conducted on the Centers for Disease Control and Prevention (CDC) website and the Journal of the American Medical Association (JAMA). Nine pertinent articles were retrieved and served as the basis for this clinical review.

Results: There is a lack of evidence showing that SNRIs offer superior treatment efficacy than TCAs in the treatment of fibromyalgia, though they may offer greater efficacy for patients with comorbid depression or anxiety.

Conclusion: Fibromyalgia is a complex syndrome and treatment can vary widely. While the articles reviewed do not demonstrate that SNRIs have superior efficacy than amitriptyline, they suggest that SNRIs have similar treatment effects and may have less reported side effects. Moreover, given the complex nature of fibromyalgia and the several treatment methods, further research is needed.

Keywords: Fibromyalgia, Chronic pain, Tricyclic, Serotonin Norepinephrine, SNRI.


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