Which class of antidepressants is commonly used to treat fibromyalgia symptoms via monoamine reuptake inhibition?

• A. SSRIs
• B. SNRIs
• C. MAOIs
• D. Tricyclic antidepressants

Answer: (B)

Fibromyalgia pain is shaped by central sensitization and a relatively weak descending pain inhibition system. Increasing brain serotonin and norepinephrine strengthens those descending inhibitory pathways, helping to dampen pain signals. The antidepressant class that blocks the reuptake of both serotonin and norepinephrine fits this goal, making it commonly used for fibromyalgia symptoms. These SNRI drugs—like duloxetine and milnacipran—address both mood and pain, which aligns well with fibromyalgia management. In contrast, SSRIs primarily raise serotonin and often have less robust analgesic effects; MAO inhibitors raise monoamines too but come with safety concerns and aren’t used for this purpose; TCAs do inhibit monoamine reuptake as well but carry more anticholinergic and other side effects and are less favored today for fibromyalgia.