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ORCID: Affiliation: 8 Neuroscience Theme, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney NSW 2006, Australia 9 Laboratory of Neurobiology and Pathological Physiology, Institute of Animal Physiology and Genetics, Academy of Sciences of the Czech Republic, 602 00 Brno, Czech Republic These authors contributed equally to this work

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There are existing medications that get used for chronic pain in these conditions, from amitriptyline for sleep and pain to newer options like the recently approved tonmya for fibromyalgia, and the honest truth is that even those more established treatments have mixed evidence records

The dominant theme in MHRA findings continues to be data integrity: between 2016 and 2023, data integrity failures accounted for nearly 40% of all critical and major GMP deficiencies, the large majority involving electronic systems. In practice, this means MHRA scrutiny extends well beyond the accuracy of the underlying science to how laboratories and manufacturing sites document, track, and manage records throughout their lifecycle