Anticholinergic Load and Fibromyalgia Treatment Analysis: Guidelines and Drug Alerts

Background: This study examines the challenges associated with pharmacological management in fibromyalgia (FM), a multifaceted syndrome characterized by widespread pain, cognitive impairment and fatigue. A comparative analysis of drug usage, potential drug interactions, and adherence to clinical guidelines highlights the critical need to evaluate how medications may contribute to symptoms such as fibro-fog and affect overall quality of life, with the aim of optimizing patient` well-being. Objectives: The primary aim of this study was to assess medication usage, identify potential drug interactions, and evaluate treatment suitability in FM patients, with a particular focus on recent pharmacological advancements and their impact on symptom management. Methods: 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, as well as to evaluate the anticholinergic burden and its potential cognitive impacts. Results: The study included 108 women with FM, with a mean age of 54.06 ± 8.43 years. Pain management medications accounted for 72.94% of total medication prescribed. The analysis revealed a significant anticholinergic burden in 50.93% of the patients, and a total of (881 alerts were recorded for potential drug interactions). Conclusions: Pharmacological reviews are essential in the management of FM, as they enhance treatment safety, minimize risks such as CNS depression and high anticholinergic burden, and help to alleviate symptoms like fibro-fog or cognitive impairment. Personalized medication approaches can improve patient outcomes and quality of life, particularly given the complexities and lack of consensus regarding FM treatment strategies.