These patients are doing the right thing! These meds are adjunctive at best and are not cost effective in terms of money or side effects. The biopsychosocial model of this disorder is the basis for treatment with non-pharmacologic therapies. Since there are no "big bucks" involved with non-pharmacologic treatment, the traditional medical model is a poor substitute that is costly and ineffective. I often have to tell patients that there is no medicine on the planet earth to put between their lips for the pain of fibromyalgia A good rheumatologist screens for medical conditions, provides cognitive therapy and guidance and validation and follows the patient for at least a year in case something changes. A bad rheumatologist diagnoses sero-negative RA and starts Remicade infusions! Medicalization of Misery as Dr. Norton Hadler has written about.