Introduction:

Fibromyalgia is a chronic rheumatological syndrome, of unknown aetiology, defined as widespread pain and a multiplicity of symptoms. Its treatment remains an important challenge. Some antipsychotic drugs, such as quetiapine, have been studied and used in this syndrome as adjunctive therapy. However, there is still controversy regarding their effectiveness and safety. The aim of this paper was to assess the efficacy, tolerability, and safety of quetiapine in adults with fibromyalgia.

Methods:

The articles were obtained through bibliographic research on different scientific platforms using the MeSH terms ‘quetiapine’ and ‘fibromyalgia’. Studies were included according to the following PICOS model criteria: (P) adults diagnosed with fibromyalgia; (I) therapeutic plan using quetiapine; (C) placebo or another type of comparator; (O) symptom relief and tolerability and safety profiles; (S) systematic reviews and randomized controlled clinical trials. The Strength of Recommendation Taxonomy scale from the American Academy of Family Physicians was used to assess levels of evidence and to assign the strength of recommendation.

Results:

From the 66 articles initially found, three randomized controlled trials were included. Although most studies reported somewhat heterogeneous and inconsistent results, they seem to present some advantages in symptom control with quetiapine. However, there is no robust evidence to prove an unequivocal benefit. The authors reported good tolerance and the absence of severe adverse effects with its use.

Conclusions:

Current evidence is of poor quality, non-bias free, and difficult to generalize, despite being apparently favourable to some symptom relief in patients with fibromyalgia (strength of recommendation B). This positive profile is not supported by statistical significance. Adverse effects may limit its clinical usefulness. New studies with more specific, clear, and consensual structures and methodology are needed in order to reach quality conclusions.

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