Kim 2013.

Study characteristics
Methods	Design: cross‐over Duration: 6 weeks Assessment: baseline and post‐intervention Country: USA
Participants	Pain condition: fibromyalgia Population: adults with fibromyalgia Minimum pain intensity: no Inclusion criteria Diagnosed with fibromyalgia by their rheumatologist or physician, with confirmation of the diagnosis by ACR criteria Exclusion criteria Severe physical and mental health comorbidities (except depression) Total participants randomised: 20 Age in years (mean, SD): 47.6 (9.1) Gender: 18/20 were female Pain duration in years (mean, SD): NR
Interventions	Placebo Inert Milnacipran 12.5‐200 mg SNRI Forced titration to maximum tolerated dosage
Outcomes	AEs SAEs
Missing data methods	ITT with LOCF
Funding source	Pharmaceutical: "This study was supported by Forest Laboratories through an Investigator‐Initiated Award."
Conflicts of interest	"Dr Marks has served as a consultant to Forest, Dey, Gilead, and TTK; has received grant/research support from Bristol‐Myers Squibb, Dov, Eli Lilly, Endo, GlaxoSmithKline, Janssen, Johnson & Johnson, Pfizer, Saegis, Sepracor, and Somaxon; and has served on the speakers or advisory boards of Alkermes, Bristol‐Myers Squibb, Dey, Pfizer, and Sunovion. Dr Masand has served as a consultant to Forest, Lundsbeck, Merck, Pfizer, and Sunovion; has received grant/research support from Forest; has received honoraria from or served on the speakers or advisory boards of Forest, GlaxoSmithKline, Merck, Pfizer, and Sunovion; and is a stock shareholder in Global Medical Education. Dr Millet has received grant/research support from Forest. Dr Keefe has served as a consultant to Abbvie, Akebia, Amgen, Asubio, BiolineRx, Biomarin, Boehringer‐Ingelheim, Eli Lilly, EnVivo, Lundbeck, Merck, Mitsubishi, Novartis, Otsuka, Pfizer, Roche, Shire, Sunovion, Takeda, and Targacept; has received grant/research support from Feinstein Institute for Medical Research, GlaxoSmithKline, National Institute of Mental Health, PsychoGenics, Research Foundation for Mental Hygiene, and Singapore Medical Research Council; is a stock shareholder in NeuroCog Trials; and has received royalties from the Brief Assessment of Cognition in Schizophrenia (BACS) and MATRICS Battery (BACS Symbol Coding). Dr Patkar has served as a consultant to Dey, Forest, Gilead, and TTK; has received grant/research support from Dey, Duke Endowment, Envivo, Forest, Janssen, Lundbeck, National Institutes of Health (National Institute on Drug Abuse/National Institute on Alcohol Abuse and Alcoholism), Pfizer, Shire, Sunovion, and Titan; and has served on the speakers or advisory boards of Alkermes, BristolMyers Squibb, Dey, Pfizer, and Sunovion. Dr Kim and Mss Rele and Yerramsetty report no conflicts of interest related to the subject of this article.
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Randomisation methods not specified
Allocation concealment (selection bias)	Unclear risk	Allocation procedures not described
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Says double‐blinded but no specific information given regarding identical medication
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Self‐reported outcomes by participants but not enough information regarding blinding
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Authors state that the same 20 participants completed both phases of study (20) but LOCF numbers are 31. Not clear about ITT, imputation or handling of missing data Attrition Not clearly reported, unable to establish total attrition and attrition per arm
Selective reporting (reporting bias)	Unclear risk	Protocol lists pain, fatigue and cognition prospectively but doesn't mention any of the secondary measures. A lot of missing outcomes
Other bias	Unclear risk	Data NR in numerical forms ‐ all secondary outcomes are classified e.g. "transient change" which has no interpretation