The present study compared the efficacy and tolerability of combined pregabalin (PGB) and milnacipran (MLN) in female patients with fibromyalgia (FM) with PGB monotherapy.

It included 58 female patients diagnosed with FM and randomized them into two groups. Group 1 patients (n=29) received PGB monotherapy (150 mg twice daily), and group 2 patients (n=29) received combined PGB (150 mg twice daily) and MLN (50 mg twice daily) for three months. During the initial visit, the researchers assessed the patients via a visual analog scale (VAS) for pain and the FM impact questionnaire (FIQ). After three months, patients underwent FIQ, VAS, and Leeds Sleep Evaluation Questionnaire assessment.

The study found the median disease duration as two years in group 1 (6 months to 5 years) and two years in group 2 (6 months to 12 years), and the dropout rate of 20.7% in group 1 and 10.3% in group 2. The follow-up evaluation showed significantly improved VAS and FIQ scores in both groups. Group 2 showed a statistically insignificant higher percentage of patients demonstrating improved pain, disease impact, and sleep pattern.

Both PGB as a monotherapy and in combination with MLN possess adequate efficacy in treating patients with FM. However, combined therapy is not superior to monotherapy.

Fattah YHA, Elnemr R. Efficacy of pregabalin as a monotherapy versus combined pregabalin and milnacipran in the management of fibromyalgia. International Journal of Rheumatic Diseases. 2020;23(11): 1474-1480. https://doi.org/10.1111/1756-185X.13953