Fibromyalgia Treatment: Medications That Can and Can’t Help
Doctors prescribe various types of medications for fibromyalgia treatment.
While medications can help relieve the pain, they likely won't eliminate the
pain entirely. But they can make life with fibromyalgia much better -- helping
you sleep restfully, easing depression and anxiety, and improving your overall
sense of well-being.
As you discuss medications with
your doctor, ask questions. Some medications work better than others as a
fibromyalgia treatment. Some have serious side effects, including potential for
addiction.
Because no fibromyalgia medication will provide all the relief you need, work
closely with your doctor. You need a complete treatment plan that also involves
lifestyle changes -- all geared to help you feel better.
Seizure Medicine (Anticonvulsants)
- Lyrica (pregabalin) is a new fibromyalgia treatment -- an anticonvulsant
that is the only FDA-approved medication for fibromyalgia. Lyrica is also
approved for reducing some types of seizures, and for treating nerve pain caused
by shingles and diabetes. Clinical trials show that Lyrica reduces pain and
improves daily functioning in many people with fibromyalgia. The most common
side effects included mild to moderate dizziness and sleepiness.
- Another antiseizure medication called Neurontin (gabapentin) has also been
studied as a fibromyalgia medication. It is not FDA-approved for fibromyalgia.
Antidepressants
Antidepressants can help relieve pain and promote better-quality sleep, even
if you aren't depressed. They are typically prescribed in low doses for
fibromyalgia treatment.
- Tricyclic antidepressants, such as Amitril or Elavil (amitriptyline),
Sinequan (doxepin), Tofranil (imipramine), Aventyl or Pamelor (nortriptyline),
or trazodone (Desyrel) appear to have multiple positive effects in relieving
fibromyalgia. These drugs work with the serotonin and norepinephrine nerve
transmitters in the brain. They have been found to relieve muscle pain and
spasm, and improve deep restorative sleep. However, they may have side effects
like weight gain, dizziness, tiredness, and dry mouth.
- Selective serotonin reuptake inhibitors (SSRIs), such as Prozac
(fluoxetine), Paxil (paroxetine), or Zoloft (sertraline) may reduce depression
and fatigue, and help manage pain by increasing the serotonin in the brain.
- Research suggests that adding Prozac (fluoxetine) to low-dose Amitril or
Elavil (amitriptyline) reduces muscle pain, anxiety, and depression in
fibromyalgia patients. The combination helps promote restful sleep and improve
overall well-being -- helping patients feel less fatigued, more cheerful, and
alert.
- An SSRI like Prozac and tricyclic antidepressant like Elavil are often
prescribed together to reduce muscle pain, anxiety, and depression -- and
improve sleep as well as overall sense of well-being.
- Serotonin and norepinephrine reuptake inhibitors (SNRIs) -- known as mixed
(or dual) reuptake inhibitors -- may help relieve fibromyalgia pain and
depression, and improve functioning. Cymbalta (duloxetine), Desyrel
(trazodonel), and Effexor (venlafaxine) have shown promise.
Analgesics
Analgesics can be used as a treatment for fibromyalgia -- helping break
cycles of pain, relieving flare-up pain, and reducing muscle spasms.
- Anti-inflammatory drugs like ibuprofen and naproxen have limited use as
fibromyalgia medications. Take these only after talking with your doctor. They
have serious side effects when used long-term -- and may interact negatively
with other medications you are taking. Acetaminophen (like Tylenol) is a better
choice because there is less risk of complications -- but too much can lead to
liver problems.
- Ultram (tramadol) and Ultracet (tamadol/acetaminophen) are prescription pain
relievers that may be helpful as fibromyalgia medications.
- The muscle relaxant Flexeril (cyclobenzaprine) can help reduce pain and
improve sleep.
- Local injections of analgesics and/or cortisone at painful trigger points
are especially effective in breaking cycles of pain and muscle spasm.
Other Medications
Narcotics and cortisone medications are not used as a treatment for
fibromyalgia. They have not been shown to be beneficial, and long-term use makes
you dependent on these drugs.
Benzodiazepines like Klonopin (clonazepam), Valium (diazepam), and Ativan
(lorazepam) can help relieve symptoms of fibromyalgia -- but they also have the
potential for addiction.
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