Abstract
Introduction Fibromyalgia is a chronic pain disorder characterized by widespread pain, fatigue, and sleep disturbances. The purpose of this study was to compare how well duloxetine, pregabalin, and milnacipran worked for fibromyalgia patients in terms of pain management, quality of life, and sleep quality. Methodology A prospective cohort research study with 193 fibromyalgia patients was carried out at the Abbas Institute of Medical Sciences, Muzaffarabad, Pakistan. For a total study duration of nine months, participants were prescribed milnacipran, pregabalin, or duloxetine for six months, and followed up monthly for an additional three months after completing therapy. At baseline and at the conclusion of the study, measures of pain intensity, quality of life (Fibromyalgia Impact Questionnaire, FIQ), and sleep quality (Pittsburgh Sleep Quality Index, PSQI) were taken. Analysis of variance (ANOVA) and paired t-tests were among the statistical studies carried out. Results Significant improvements in pain, quality of life, and sleep quality were shown by all three drugs. The most significant benefits were from duloxetine, which dramatically reduced pain and improved sleep and quality of life (p < 0.05). Pregabalin was less successful at improving quality of life than it was at reducing pain and promoting better sleep. Milnacipran had less of an effect on quality of life but showed modest effectiveness in managing fatigue and reducing discomfort. Due to moderate side effects, such as nausea and dizziness, duloxetine had greater rates of discontinuation. Conclusion Duloxetine was the most effective treatment, improving pain, quality of life, and sleep quality. Pregabalin is beneficial for pain and sleep management, while milnacipran remains a viable option for those with predominant fatigue. These results support the use of these medications in fibromyalgia treatment.