Jason Nikirk1, Josephine Chiu1, Amayah Brown1, Megan Woolford1
1Sam Houston State University
Objective:
We present the case of a 33-year-old female patient with chronic generalized musculoskeletal pain, fatigue, and a history of ADHD. Atomoxetine, a selective norepinephrine reuptake inhibitor, was prescribed as the primary intervention to target her ADHD. Interestingly, the patient's ADHD and fibromyalgia symptoms significantly improved within the first 3 weeks with continuous relief over the next 28 months.
Background:
There is a proposed association that exists between attention-deficit disorders and chronic pain conditions. This case represents an interesting phenomenon previously reported in the literature, specifically, the improvement in fibromyalgia symptoms with treatment of comorbid ADHD. While atomoxetine is not the standard treatment for fibromyalgia, our case report suggests the potential dual treatment effects of this nonstimulant medication which warrants further research. This report aims to provide further evidence regarding the consideration of atomoxetine in alleviating ADHD-related symptoms and fibromyalgia-associated pain and cognitive impairments.
Results:
Within 3 weeks of starting atomoxetine the patient noted drastic improvements in her ADHD symptoms. The patient also reported substantial improvements in her fatigue and chronic pain. A low dose of atomoxetine appeared to aid markedly with her fibromyalgia symptoms. Within 2 months the patient reported a near-complete resolution of the fatigue, musculoskeletal pain, and insomnia that had been present for more than 5 years. She eventually discontinued atomoxetine in February of 2023 (28 months later) due to a side effect of blurred vision. Interestingly, even after discontinuing atomoxetine, the patient reported a sustained reduction in chronic pain compared to her initial visit.
Conclusions:
This case report suggests that atomoxetine may be a promising adjunct treatment for patients with comorbid ADHD and fibromyalgia. Further research to understand the potential mechanism of action of atomoxetine in targeting both disorders could have profound implications for the treatment of comorbid conditions involving chronic pain and cognitive deficits.