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==Zdravljenje==
AsKot withpri manyštevilnih otherdrugih [[Medicallysindromih, unexplainedkjer physicalvzrok symptoms|medicallyni unexplained syndromes]]pojasnjen, theretudi isza nofibromialgijo universallyne acceptedobstaja treatmentsplošno orsprejeta cureučinkovita foroblika fibromyalgia,zdravljenja. andZdravljenje treatmenttemelji typicallyzlasti consistsna oflajšanju symptom managementsimptomov. DevelopmentsDosežki inv thepoznavanju understandingpatofiziologije offibromialgije theso pathophysiologypomagali ofpri theizboljšanju disorderzdravljenja havez leddoločenimi tozdravili, improvementsvedenjskimi intervencijami in treatment,telesno which includevadbo. prescriptionObravnava medicationbolnika, behavioralki intervention,vključuje andnjegovo exercise.izobraževanje, Indeeduporabo zdravil, integratedizvajanje treatment[[aerobna planstelesna thatvadba|aerobne incorporatetelesne medication,vadbe]] patientin education,[[kognitivna aerobicvedenjska exerciseterapija|kognitivne andvedenjske cognitiveterapije]], behavioralse therapyje haveizkazala beenza shownučinkovito topri belajšanju effectivebolečin in alleviating paindrugih ands otherfibromialgijo fibromyalgia-relatedpovezanih symptomssimptomov.<ref name=Goldenberg2008>{{cite journal | author = Goldenberg DL | title = Multidisciplinary modalities in the treatment of fibromyalgia | journal = J Clin Psychiatry | volume = 69 | issue = 2 | pages = 30–4 | year = 2008 | pmid = 18537461 }}</ref>
The [[Association of the Scientific Medical Societies in Germany]],<ref name=German>{{cite journal | vauthors = Sommer C, Häuser W, Alten R, Petzke F, Späth M, Tölle T, Uçeyler N, Winkelmann A, Winter E, Bär KJ | title = Drug therapy of fibromyalgia syndrome. Systematic review, meta-analysis and guideline | journal = Schmerz | volume = 26 | issue = 3 | pages = 297–310 | date = June 2012 | pmid = 22760463 | doi = 10.1007/s00482-012-1172-2 | url = http://www.awmf.org/fileadmin/user_upload/Leitlinien/041_D_Interdisziplinaere_V_fuer_Schmerztherapie/041-004le_S3_Fibromyalgiesyndrom_2012-04.pdf#page=43 | url-status=dead | archiveurl = https://web.archive.org/web/20130216060923/http://www.awmf.org/fileadmin/user_upload/Leitlinien/041_D_Interdisziplinaere_V_fuer_Schmerztherapie/041-004le_S3_Fibromyalgiesyndrom_2012-04.pdf#page=43 | archivedate = 16 February 2013 | df = dmy-all }}</ref> the [[European League Against Rheumatism]]<ref name=EULAR>{{cite journal | vauthors = Carville SF, Arendt-Nielsen S, Bliddal H, Blotman F, Branco JC, Buskila D, Da Silva JA, Danneskiold-Samsøe B, Dincer F, Henriksson C, Henriksson KG, Kosek E, Longley K, McCarthy GM, Perrot S, Puszczewicz M, Sarzi-Puttini P, Silman A, Späth M, Choy EH | title = EULAR evidence-based recommendations for the management of fibromyalgia syndrome | journal = Ann. Rheum. Dis. | volume = 67 | issue = 4 | pages = 536–41 | date = April 2008 | pmid = 17644548 | doi = 10.1136/ard.2007.071522 | url = http://www.enfa-europe.eu/assets/downloads/eular.pdf | url-status = dead | archiveurl = https://web.archive.org/web/20140523230934/http://www.enfa-europe.eu/assets/downloads/eular.pdf | archivedate = 23 May 2014 | df = dmy-all | access-date = 21 April 2013 }}</ref> and the [[Canadian Pain Society]]<ref name=Canadian>[http://fmguidelines.ca/?page_id=21 2012 Canadian guidelines for the diagnosis and management of fibromyalgia syndrome] {{webarchive|url=https://web.archive.org/web/20130611010115/http://fmguidelines.ca/?page_id=21 |date=11 June 2013 }}</ref> currently publish guidelines for the diagnosis and management of FMS.
=== Zdravila ===
Za zdravljenje fibromialgije so bila preizkušena nekatera zdravila za zdravljenje nevropatske bolečine. Ta zdravila vključujejo [[antidepresiv]]e, [[nevromodulator]]je in protibolečinska zdravila. Pri bolnikih, ki imajo tudi sindrom nemirnih nog, so lahko primerni dopaminski agonisti. Uporaba običajnih analgetikov za zdravljenje fibromialgije ni priporočljiva. Pri zdravljenju so ob uporabi zdravil pomembni tudi nefarmakološki ukrepi.<ref name=Zaletel/>
Kanadske in ameriške oblasti so za zdravljenje fibromialgije odobrile [[pregabalin]]<ref name="FDAFibro">{{cite press release |url=https://www.fda.gov/bbs/topics/NEWS/2007/NEW01656.html |title=FDA Approves First Drug for Treating Fibromyalgia |publisher=U.S. [[Food and Drug Administration]] |date=21. 6. 2007 |accessdate=14. 1. 2008 |url-status=live |archiveurl=https://web.archive.org/web/20080221172848/https://www.fda.gov/bbs/topics/NEWS/2007/NEW01656.html |archivedate=21. 2. 2008 |df=dmy-all }}</ref> in [[duloksetin]]. V ZDA je dovoljenje za promet z zdravilom za indikacijo fibromialgije prejelo tudi zdravilo [[milnacipran]], [[Evropska agencija za zdravila]] pa ga ni odobrila.<ref name="Doc. Ref.: EMA/814249/2009">{{cite web |last=European Medicines Agency |title=Questions and answers on the recommendati on for the refusal of the marketing authorisation for Milnacipran Pierre Fabre Médicament/Impulsor |url=http://www.ema.europa.eu/docs/en_GB/document_library/Summary_of_opinion_-_Initial_authorisation/human/001034/WC500089875.pdf |publisher=European Medicines Agency |accessdate=30. 5. 2013 |url-status=live |archiveurl=https://web.archive.org/web/20140222154105/http://www.ema.europa.eu/docs/en_GB/document_library/Summary_of_opinion_-_Initial_authorisation/human/001034/WC500089875.pdf |archivedate=22. 2. 2014 |df=dmy-all }}</ref>
==== Antidepresivi ====
AntidepressantsAndidepresivi areso "associatedlahko withpri improvementsbolniku ins painfibromialgiju učinkoviti pri lajšanju bolečine, depressiondepresije, fatigueutrujenosti, sleepmotnjah disturbances,spanca andin health-relatednasploh qualitylahko ofizboljšajo lifebolnikovo inz peoplezdravjem withpovezano FMS[[kakovost življenja]]."<ref name="Treatment of fibromyalgia syndrome with antidepressants: a meta-analysis.">{{cite journal |vauthors=Häuser W, Bernardy K, Uçeyler N, Sommer C |title=Treatment of fibromyalgia syndrome with antidepressants: a meta-analysis |journal=JAMA |volume=301 |issue=2 |pages=198–209 |date=Januaryjanuar 2009 |pmid=19141768 |doi=10.1001/jama.2008.944}}</ref> TheCilj goalzdravljenja ofz antidepressantsantidepresivi shouldje belajšanje symptomsimptomov. reductionZlasti andpri ifdolgotrajni useduporabi longje term,treba theirpretehtati effectskoristi shouldin be[[neželeni evaluatedučinek|neželene against side effectsučinke]]. AManjši smalldelež numberbolnikov ofima peopleob benefituporabi significantly[[zaviralec fromprivzema theserotonina SNRIsin duloxetinenoradrenalina|zaviralcev andprivzema milnacipranserotonina andin thenoradrenalina]] ([[tricyclic antidepressantduloksetin]]sa (TCAsali [[milnacipran]]a), such asali [[amitriptylinetriciklični antidepresiv|tricikličnih antidepresivov]]. However(amitriptilin) znatno izboljšanje stanja, manyvendar pa so pri številnih bolnikih neželeni peopleučinki experienceizrazitejši moreod adversesame effectsučinkovitosti thanteh benefitszdravil.<ref name="Häuser-2012">{{cite journal |vauthors=Häuser W, Wolfe F, Tölle T, Uçeyler N, Sommer C |title=The role of antidepressants in the management of fibromyalgia syndrome: a systematic review and meta-analysis |journal=CNS Drugs |volume=26 |issue=4 |pages=297–307 |date=AprilaApril 2012 |pmid=22452526 |doi=10.2165/11598970-000000000-00000}}</ref><ref>{{Cite journal|last=Cording|first=Malene|last2=Derry|first2=Sheena|last3=Phillips|first3=Tudor|last4=Moore|first4=R. Andrew|last5=Wiffen|first5=Philip J.|date=2015-10-20|title=Milnacipran for pain in fibromyalgia in adults|url=|journal=The Cochrane Database of Systematic Reviews|volume=|issue=10|pages=CD008244|doi=10.1002/14651858.CD008244.pub3|issn=1469-493X|pmid=26482422|pmc=6481368}}</ref> While amitriptyline has been used as a first line treatment, the quality of evidence to support this use is poor.<ref>{{cite journal |last1=Moore |first1=RA |last2=Derry |first2=S |last3=Aldington |first3=D |last4=Cole |first4=P |last5=Wiffen |first5=PJ |title=Amitriptyline for fibromyalgia in adults |journal=The Cochrane Database of Systematic Reviews |date=31. July7. 2015 |volume=7 |issue=7 |pages=CD011824 |doi=10.1002/14651858.CD011824|pmc=6485478 }}</ref>
Od začetka jemanja antidepresivov do nastopa učinka lahko traja precej časa, in sicer do tri mesece pri amitriptilinu in med tri in šest mesecev pri doluksetinu, milnacipranu in pregabalinu. Ob prenehanju jemanja nekaterih zdravil se lahko pojavi [[odtegnitveni sindrom]], zato se priporoča postopno zmanjševanje odmerka..<ref name="pmid19623319" />
It can take up to three months to derive benefit from the antidepressant amitriptyline and between three and six months to gain the maximal response from duloxetine, milnacipran, and pregabalin. Some medications have the potential to cause withdrawal symptoms when stopping so gradual discontinuation may be warranted particularly for antidepressants and pregabalin.<ref name="pmid19623319" />
There is tentative evidence that the benefits and harms of [[selective serotonin reuptake inhibitors]] (SSRIs) appear to be similar.<ref>{{cite journal |last1=Häuser |first1=Winfried |last2=Walitt |first2=Brian |last3=Fitzcharles |first3=Mary-Ann |last4=Sommer |first4=Claudia |title=Review of pharmacological therapies in fibromyalgia syndrome |journal=Arthritis Research & Therapy |date=1 January 2014 |volume=16 |issue=1 |pages=201 |doi=10.1186/ar4441 |pmid=24433463 |pmc=3979124 |issn=1478-6362}}</ref> SSRIs may be used to treat depression in people diagnosed with fibromyalgia.<ref>{{Cite journal|last=Walitt|first=Brian|last2=Urrútia|first2=Gerard|last3=Nishishinya|first3=María Betina|last4=Cantrell|first4=Sarah E|last5=Häuser|first5=Winfried|date=2015-06-05|title=Selective serotonin reuptake inhibitors for fibromyalgia syndrome|journal=Cochrane Database of Systematic Reviews|issue=6|pages=CD011735|doi=10.1002/14651858.cd011735|pmid=26046493|pmc=4755337|issn=1465-1858}}</ref>
==Prognoza==
AlthoughFibromialgija ni [[degenerativna boleze]]n in itselfne neitherskrajšuje degenerativepričakovane norživljenjske fataldobe, theje chronicpa painkronična ofbolečina fibromyalgiatrajna isin pervasiverazširjena andpo persistenttelesu. MostVečina peoplebolnikov withporoča, fibromyalgiada reportsimptomi thatvztrajajo theirin symptomsse done not improve over timeizboljšujejo. AnBolezen evaluationvpliva ofna 332različna consecutivepodročja newživljenja, peoplekot withso fibromyalgiadelo, foundizobraževanje thatter disease-relatedzmožnost factors such as pain and psychological factors such as work statusposameznika, helplessness, education, and coping ability had an independent and significant relationship toda FMse symptomspoprijema severityz andživljenjskimi functiontežavami.<ref>{{cite journal |vauthors=Goldenberg DL, Mossey CJ, Schmid CH | title = A model to assess severity and impact of fibromyalgia | journal = [[J. Rheumatol.]] | volume = 22 | issue = 12 | pages = 2313–8 | date = December 1995 | pmid = 8835568 }}</ref>
== Epidemiologija ==
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