1st line therapy in fibromyalgia,”amitryptilline (TCAs), 2nd line: pregabilin June 22, 2017 mfadmin Medicine Average Rating 0 out of 5 stars. 0 votes.You must log in to submit a review. 1st line therapy in fibromyalgia,”amitryptilline (TCAs), 2nd line: pregabilin duloxetine”