Has anyone found a pathophysiologic cause for fibromyalgia? The symptoms of fibromyalgia and various psychiatric illnesses are very similar, and I wonder if we should be treating a psychiatric condition rather than a medical one.
—Bret Bellard, MD, Carson City, Nev.

Pain amplification in fibromyalgia is likely caused by neurohormonal abnormalities in the central nervous system. In particular, deficiencies of three monamines—serotonin, norepinephrine, and dopamine—have been linked to depression. Correcting these deficiencies often results in improvement in fibromyalgia symptoms as well as in the concomitant psychiatric problems noted in at least 50% of patients.
— Jack Waxman, MD (110-9)

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