Treatment of fibromyalgia with cyclobenzaprine: A meta-analysis

Arthritis Rheum. 2004 Feb 15;51(1):9-13. doi: 10.1002/art.20076.


Objective: To systematically review the effectiveness of cyclobenzaprine in the treatment of fibromyalgia.

Methods: Articles describing randomized, placebo-controlled trials of cyclobenzaprine in people with fibromyalgia were obtained from Medline, EMBase, Psyclit, the Cochrane Library, and Federal Research in Progress Database. Unpublished literature and bibliographies were also reviewed. Outcomes, including global improvement, treatment effects on pain, fatigue, sleep, and tender points over time, were abstracted.

Results: Five randomized, placebo-controlled trials were identified. The odds ratio for global improvement with therapy was 3.0 (95% confidence interval [95% CI] 1.6-5.6) with a pooled risk difference of 0.21 (95% CI 0.09-0.34), which calculates to 4.8 (95% CI 3.0-11) individuals needing treatment for 1 patient to experience symptom improvement. Pain improved early on, but there was no improvement in fatigue or tender points at any time.

Conclusion: Cyclobenzaprine-treated patients were 3 times as likely to report overall improvement and to report moderate reductions in individual symptoms, particularly sleep.

Publication types

  • Meta-Analysis

MeSH terms

  • Amitriptyline / analogs & derivatives*
  • Amitriptyline / therapeutic use*
  • Databases, Factual
  • Fatigue / drug therapy
  • Fatigue / etiology
  • Fatigue / physiopathology
  • Female
  • Fibromyalgia / complications
  • Fibromyalgia / drug therapy*
  • Fibromyalgia / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Muscle Relaxants, Central / therapeutic use*
  • Pain / drug therapy
  • Pain / etiology
  • Pain / physiopathology
  • Placebos
  • Randomized Controlled Trials as Topic
  • Treatment Outcome


  • Muscle Relaxants, Central
  • Placebos
  • Amitriptyline
  • cyclobenzaprine