Fibromyalgia is characterized by diffuse musculoskeletal pain, fatigue, sleep disturbance, headaches, and cognitive and affective disturbance. The aetiological pathway is not clearly understood nor is there a clearly defined pathophysiological profile for the disorder that distinguishes it as a diagnosis.

To investigate the efficacy of 20 mg escitalopram monotherapy in management of depressive symptoms, pain, fatigue and sleep.

To demonstrate efficacy of escitalopram in improving depressive and pain symptoms as measured by primary and secondary outcome measures.

60 subjects were randomized to treatment or control group and evaluated at 4,8 and 12 weeks using MADRAS, McGill pain questionnaire, fibromyalgia impact score and sleep questionnaires.

Mean MADRAS score was significantly lower in the treatment group (14.96 ± 1.02 vs 18.12 ± 1.05; p = 0.03) as compared to the control group. When the change from baseline on MADRAS score was compared between the groups, the reduction was even more apparent in the treatment group (−12.49 ± 1.48 vs − 4.77 ± 1.54; p = 0.001).Mean FIBROMYALGIA score was significantly lower in the treatment group as compared to the control group (54.20 ± 2.09 vs 64.93 ± 2.14; p < 0.001). The reduction was much higher in the treatment group than the control group (−21.31 ± 2.94 vs − 2.79 ± 3.03; p < 0.001).

Positive statistically significant results for treatment group on all primary outcome measures of MADRAS and fibromyalgia impact score questionnaire.