Symptomatic improvement in fibromyalgia after treatment of comorbid attention deficit hyperactivity disorder: a case report

治疗合并注意力缺陷多动障碍后纤维肌痛症状改善:病例报告

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Abstract

BACKGROUND: Attention deficit hyperactivity disorder is a common disorder that has an association with fibromyalgia. The connection between the two is incompletely understood but may be due to specific neurotransmitter abnormalities. Atomoxetine, a selective norepinephrine reuptake inhibitor mainly used for attention deficit hyperactivity disorder, has shown promise in relieving symptoms of attention deficit and chronic pain. However, its effectiveness in treating both conditions simultaneously has not been thoroughly studied. CASE PRESENTATION: We present the case of a 33-year-old white female patient with attention deficit hyperactivity disorder and generalized pain and fatigue from suspected fibromyalgia syndrome. Investigative labs were unremarkable. Atomoxetine was prescribed as the primary treatment intervention to target attentive symptoms. Interestingly, the patient's symptoms related to both attention deficit hyperactivity disorder and suspected fibromyalgia significantly improved within the first 2 weeks, with continuous relief over the next 9 months. The patient also reported improved quality of mood, sleep, and tolerance of physical activity. CONCLUSION: This case of a 33-year-old female with attention deficit hyperactivity disorder and chronic pain suspicious for fibromyalgia showed the improvement of pain symptoms with atomoxetine. While a few published cases have demonstrated a similar finding, this case is notable for the dramatic improvement and the response to a nonstimulant medication-atomoxetine. This case highlights the need for further research into the connection between attention deficit hyperactivity disorder and chronic pain, as well as the mechanism behind the effects of atomoxetine on pain.

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