Recently, the FDA gave its first two approvals for medications to treat fibromyalgia (FM): first Lyrica (pregabalin) and then Cymbalta (duloxetine). While it is nice that FM is receiving some attention from big pharma, the badge of FDA approval should be taken with a grain of salt.

It has become increasingly clear that depressed patients quite often suffer from some degree of physical pain, which may adversely impact treatment outcome. Indeed, research suggests that as the pain severity of patients increases, the odds of achieving a successful antidepressant response decreases (Bair MJ et al., Psychosom Med 2004;66:17-22).

Dr. Clauw, you’ve devoted your career to the research and clinical care of patients with fibromyalgia. How do you approach the diagnosis of this illness?