Review of fibromyalgia treatment guidelines: part 2 – pharmacological treatment

Abstract

Fibromyalgia is a complex condition characterized by widespread chronic pain, fatigue, and sleep disturbances, which significantly affect quality of life. Its pathophysiology involves central sensitization (CS) and changes in neurotransmitters. Management is challenging and requires a multidisciplinary approach that integrates pharmacological and nonpharmacological treatments. This consensus, which is based on the BASCE system, presents updated guidelines for drug and nondrug treatments. The methodology focused on the evaluation of meta-analyses and systematic reviews of the literature and on voting by experts from the Brazilian Society of Rheumatology, ensuring recommendations with at least 70% agreement. Divided into two articles, this article addresses pharmacological strategies, incorporating recent advances to optimize clinical management and promote uniformity in professional practice.