These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the Mount Sinai School of Medicine and MBL Communications, Inc. The Mount Sinai School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.

The Mount Sinai School of Medicine designates the Expert Panel Supplement for a maximum of 2 AMA PRA Category 1 CreditsTM, and the Interactive Case Studies for a maximum of AMA PRA Category 0.75 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in each activity.

Interactive Case Studies
After viewing the two online case studies, you will be prompted to fill out a registration form followed by a posttest and evaluation. Upon successful completion of the posttest (70% or better) and evaluation, your CME certificate will be available for you to print.

Expert Panel Supplement
After reading the supplement, you will be prompted to fill out a registration form followed by a posttest and evaluation. Upon successful completion of the posttest (70% or better) and evaluation, your CME certificate will be available for you to print.

December 2009



December 31, 2010



The estimated time to complete the Expert Panel Supplement is 2 hours. The estimated time to complete the Interactive Case Studies is 30 minutes.

It is the policy of the Mount Sinai School of Medicine to ensure objectivity, balance, independence, transparency, and scientific rigor in all CME-certified educational activities. All faculty participating in the planning or implementation of a sponsored activity are expected to disclose to the audience any relevant financial relationships and to assist in resolving any conflict of interest that may arise from the relationship. Presenters must also make a meaningful disclosure to the audience of their discussions of unlabeled or unapproved drugs or devices. This information will be available as part of the course material.

Dr. Staud is a consultant to Jazz and has received honoraria from Forest and Jazz.

Dr. Mease is a consultant to, an independent contractor for, and has received research support from Allergan, Boehringer-Ingelheim, Cypress, Eli Lilly, Forest, Jazz, Pfizer, and Wyeth; and is on the advisory board and has received honoraria from Cypress, Forest, Pfizer, and Wyeth. Dr. Mease discusses unapproved/experimental uses of gabapentin, tricyclic antidepressants, and analgesics for the treatment of fibromyalgia.

Dr. Williams is a consultant to Eli Lilly, Forest, and Pfizer.

Dr. Chou has received honoraria from AstraZeneca, Bristol-Myers Squibb, Eli Lilly, GlaxoSmithKline, Janssen, and Pfizer.

Dr. Serban reports no affiliation with or financial interest in any organization that may pose a conflict of interest.

Fibromyalgia (FM) is the most common chronic pain syndrome encountered in general medicine, estimated to affect 5 million American adults. FM involves multiple clinical domains, including pain, fatigue, sleep disturbances, depression, and cognitive impairment. Patients with FM report significant negative impact of the illness on social and occupational function and overall quality of life. Society bears a substantial disease burden associated with FM, not only in direct health care costs but also in productivity loss to employers.

Much progress has been made in understanding FM, yet management of the condition continues to confound physicians and frustrate patients. The complex interactions between neurobiological, psychological, and functional/behavioral components of FM, as well as the poor response of patients to conventional pain therapies have proven particularly challenging. Research has shown that a multimodal management program yields the most benefit to patients. To implement this multimodal treatment paradigm, physicians—including primary care physicians, neurologists, and psychiatrists—need clear direction regarding the diagnosis of FM, available pharmacologic and non-pharmacologic interventions, and clinical application.

This activity is designed to meet the educational needs of primary care physicians, neurologists, and psychiatrists. Other health professionals who care for individuals with fibromyalgia may also benefit from this activity.

At the conclusion of this initiative, participants should be able to do the following:

• Utilize the diagnostic criteria for fibromyalgia (FM) based on the current biochemical and neurophysiological understanding of its etiology


• Assess the clinical domains affected by FM and their impact on quality of life


• Analyze the clinical evidence supporting the use of pharmacologic and non-pharmacologic intervention in the treatment of FM and the putative advantages of each agent


• Integrate available therapy options to develop evidence-based multidimensional treatment plans for patients with FM

The initiative content has been peer-reviewed by Stelian I Serban, MD. Review Date: January 11, 2010.

Stelian Serban, MD, is assistant professor of anesthesiology and director of acute and chronic inpatient pain service in the Department of Anesthesiology at Mount Sinai School of Medicine in New York City.

These activities are supported by an educational grant from Pfizer Inc.