Anticholinergic burden in fibromyalgia treatment analysis: Guidelines adherence and pharmacological alerts

This study examines the challenges related to pharmacological outcomes in Fibromyalgia (FM), a multifaceted syndrome characterized by widespread pain, cognitive impairment, and fatigue. It aims to evaluate medication use patterns, identify potential drug-drug interactions, assess adherence to clinical guidelines, and determine how these pharmacological factors may contribute to symptoms often described as fibro-fog and influence overall health and well-being.

This cross-sectional study analyzed medication usage and potential drug interactions in women with FM. Tools such as CheckTheMeds® and the CRIDECO Anticholinergic Load Scale were employed to assess the pharmacological appropriateness of treatments in alignment with clinical guidelines and to quantify anticholinergic burden.

A total of 881 medication alerts were reviewed, corresponding to 108 women with FM (mean age: 54.06 ± 8.43). Pain management medications accounted for 72.94% of the total medications prescribed. The analysis revealed a significant anticholinergic burden in 50.93% of the patients.

Pharmacological reviews are essential in the management of FM, as they enhance treatment safety, minimize risks such as CNS depression and excessive anticholinergic burden. Optimizing medication regimens may indirectly influence symptoms commonly reported in fibromyalgia, including those often referred to as fibro-fog, while supporting safer and more individualized treatment strategies.