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If duloxetine is contraindicated, not tolerated or ineffective, consider amitriptyline, gabapentin, or pregabalin as alternatives

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Participants were aged 1885 years with symptoms for at least 3 months, a modified MS of 5-9, MES of at least 2, and Robarts Histopathology Index score of at least 10, and the primary outcome was change in histopathology score from baseline to week 12, which showed a mean reduction of 6.4 points with 22.9% achieving remission at 12 weeks and 31.4% at 52 weeks

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