Tonmya（舌下盐酸环苯扎林）在纤维肌痛和慢性疼痛中的应用：精神药理学视角——简要评论。
完整摘要 · 中文译文
目的：综述Tonmya（盐酸环苯扎林舌下片）的精神药理学特征，该药于2025年8月15日获FDA批准，是15年多来首个新的纤维肌痛疗法，并为伴有精神科共病的病例提供整合用药的实用指导。 观察：Tonmya通过受体拮抗（5-HT2A血清素能、α1肾上腺素能、H1组胺能、M1毒蕈碱能）靶向睡眠障碍、疼痛和疲劳，舌下给药可减少日间镇静。3期RESILIENT试验数据显示疼痛显著减轻（p < 0.0001，第14周效应量0.38）、睡眠/疲劳改善以及良好的耐受性。 结论：精神科医生及合作者可在一伴有情绪/躯体特征的纤维肌痛中辅助使用Tonmya，强调患者选择、记录、监测和多学科照护，以在心身性疼痛综合征中尽量减少风险并改善结局。
完整摘要 · 英文原文
OBJECTIVE: To review the psychopharmacologic profile of Tonmya (cyclobenzaprine HCl sublingual tablets), FDA-approved August 15, 2025, as the first new fibromyalgia therapy in over 15 years, and provide practical guidance for integration in cases with psychiatric comorbidity. OBSERVATIONS: Tonmya targets sleep disruption, pain, and fatigue via receptor antagonism (5-HT2A serotonergic, α1-adrenergic, H1-histaminergic, M1-muscarinic), with sublingual delivery reducing daytime sedation. Phase 3 RESILIENT trial data showed significant pain reduction (p < 0.0001, effect size 0.38 at week 14), sleep/fatigue improvements, and favorable tolerability. CONCLUSIONS: Psychiatrists and collaborators can use Tonmya adjunctively in fibromyalgia with mood/somatic features, emphasizing patient selection, documentation, monitoring, and multidisciplinary care to minimize risks and enhance outcomes in psychosomatic pain syndromes.