Effects of 2-Aticyto Complex and D-Ribose on Pain and Clinical Course in Patients With Fibromyalgia

Inclusion Criteria: * Adults aged 18 to 65 years * Diagnosis of fibromyalgia syndrome according to the 2016 ACR criteria * Followed in a physical medicine and rehabilitation outpatient clinic for at least 1 year * Receiving pregabalin and/or duloxetine treatment for at least 3 months * Able to live independently in the community * Literate and able to record symptoms and responses * No cognitive dysfunction that would interfere with answering study questions * Able and willing to provide informed consent Exclusion Criteria: * Rheumatologic disease * Renal failure * Hepatic failure * Cardiovascular disease * Hypoglycemia or diabetes mellitus * Any neurologic disease (such as stroke, spinal cord injury, multiple sclerosis, or Parkinson's disease) * Known allergy or hypersensitivity to any active or excipient component of the study syrup * Use of any other dietary supplement or nutritional support product during the study period * Pregnancy or lactation * Active malignancy * Active infection * Severe psychiatric disease that may interfere with study participation or assessment * Refusal to participate or inability to provide informed consent