Before you start any new medication, it's important to understand what you're taking and how it will work. This is especially true if you're living with fibromyalgia, a chronic condition that requires ongoing management.
In this post, we'll take a look at the types of medication commonly prescribed to individuals with fibromyalgia and outline the benefits and potential side effects associated with each one.
So whether you're just starting your journey with fibromyalgia or are looking for ways to optimize your treatment plan, read on for more information on fibromyalgia medications.
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Many different medications are used for pain relief and fibromyalgia symptoms, including sleeping, pain medication, and antidepressant medications.
Some medications directly address fibromyalgia pain, while others improve mood-related symptoms or help sleep.
You may have to try several different medications with your doctor’s advice to find a single treatment or combination of drugs that help manage your symptoms.
Medications that have been tried and used successfully in some fibromyalgia patients include the following:
ANTIDEPRESSANTS
These are among the first medications used to treat fibromyalgia. Antidepressants are known to relieve symptoms of fatigue, improve pain symptoms, and improve one’s ability to sleep. There are two types of antidepressants used to treat fibromyalgia.
The first includes newer agents, such as selective serotonin reuptake inhibitors or SSRIs. The second includes tricyclic antidepressants, which have been used for many decades to treat depression and other related conditions.
►TRICYCLIC ANTIDEPRESSANTS
These include medications such as nortriptyline (Pamelor) and amitriptyline. These act on the levels of neurotransmitters in the brain, specifically serotonin and norepinephrine.
Tricyclic antidepressants can relax muscles that have become painful and elevate the effects of the body’s natural endorphins, which are the brain's natural painkillers.
Tricyclic antidepressants work very well for people with fibromyalgia but have various side effects that can be intolerable, including constipation, dry mouth, dry eyes, drowsiness, and dizziness.
►SSRI ANTIDEPRESSANTS
As mentioned, these are a newer class of antidepressants that affect the fatigue, sleep problems, and pain exhibited by people with fibromyalgia.
Of the many SSRI antidepressants available for use in people with fibromyalgia, three SSRIs have been studied to the greatest extent. These include milnacipran (Savella), venlafaxine (Effexor), and duloxetine (Cymbalta).
Different antidepressants react differently to the body. Therefore, what works well for one individual with fibromyalgia may be ineffective for another with the syndrome.
You may have to try more than one antidepressant or try antidepressants of different classes to find one that best controls the sleep problems, fatigue, and pain you are experiencing. Some doctors use more than one type of antidepressant simultaneously, so don’t be alarmed if you take more than one.
OVER-THE-COUNTER PAIN RELIEVERS
Some people with fibromyalgia receive pain relief by taking Acetaminophen (also known as Paracetamol). However, this has been known to increase the pain threshold to be less significantly perceived.
Other choices are non-steroidal anti-inflammatory medication or NSAIDs, including ibuprofen (most commonly known as Brufen, though also marketed as Advil, Motrin, and Nurofen) and naproxen (sold as Naprosyn and Aleve). They act on pain a d inflammation, reducing pain.
However, NSAIDs are not without side effects, including stomach upset, nausea, and stomach ulcers, especially with prolonged use. In addition, things like bleeding in the stomach and heartburn can also be side effects of taking NSAID therapy, especially if you are over 60.
It's advisable to speak to your physician if you have to take NSAID therapy for more than ten days in a row. If you have a history manage y of intestinal or stomach bleeding, or suffer from a bleeding disorder, make sure it is okay with your doctor to take these medications.
Acetaminophen has fewer side effects than NSAID therapy, but it cannot be taken safely by those who suffer from liver disease. In addition, if you take more than the recommended amount of Acetaminophen, you risk causing liver damage.
MUSCLE RELAXANTS
Some people with fibromyalgia have had relief of their muscle spasms by taking the drug cyclobenzaprine (Flexeril). This muscle relaxant can lessen muscle tension and help people sleep better. In addition, muscle relaxants act on the brain, relaxing muscles.
Unfortunately, muscle relaxants can have their own set of side effects. For example, you may notice dizziness, dry mouth, blurry vision, unsteadiness, and drowsiness.
Muscle relaxants can also decrease the seizure threshold, so they must be taken cautiously if you have a seizure disorder. In addition, in the elderly, muscle relaxants can increase the incidence of hallucinations and confusion.
Pregabalin (Lyrica) was first marketed as an anti-seizure drug, but it was found to help those with Fibromyalgia sleep better, decrease pain, and improve fatigue.
Gabapentin (Neurontin) is an anti-seizure medication that has been used on people with fibromyalgia with some success in relieving their pain.
BENZODIAZEPINES
Benzodiazepines are commonly used medications in the management of anxiety disorders. Some of them include clonazepam (Klonopin), alprazolam (Xanax), lorazepam (Ativan) and diazepam (Valium).
Besides acting on anxiety and sleep, they help relax Fibromyalgia muscle spasms. They also help relieve the symptoms of restless legs syndrome, which is commonly associated with fibromyalgia.
The biggest problem with benzodiazepines is that they are very addictive, and it is all too easy to become physically dependent on these medications. In addition, some people use these medications in doses above the recommended amounts, resulting in adverse side effects.
Tramadol (Ultram) is a prescription pain reliever used to manage Fibromyalgia pain. It's a type of narcotic medication that acts on the brain to reduce feelings of pain. However, Tramadol's addictive potential is less than that of more potent narcotic pain relievers.
Narcotic Pain Relievers are prescribed for the relief of chronic pain. Some of these include oxycodone (OxyContin), hydrocodone (Lortab), and a combination of oxycodone and Acetaminophen, marketed as Percocet. Hydrocodone and Acetaminophen are sometimes used together in a medication called Vicodin.
Because these medications are highly addictive, they should be used as a last resort to treat fibromyalgia after the other drugs have been tried without relief from fibromyalgia symptoms. If you decide to take these medications for fibromyalgia, close medical supervision is required.
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