Treating Fibromyalgia Pain: Medication Options
The Symptom-By-Symptom Approach to Treating Fibromyalgia
Fibromyalgia Pain Treatment Options
The new selective SNRIs (serotonin and norepinephrine reuptake inhibitors)help relieve fibromyalgia pain, whether the patient is depressed or not. SNRIs include Cymbalta and Effexor. Cymbalta is the only antidepressant approved by the FDA to treat fibromyalgia pain. Effexor is also used to relieve fibromyalgia pain. The FDA has also approved the SNRI Savella to treat fibromyalgia. A caveat for SNRIs: These drugs cannot be used if the patient takes a type of drug called monoamine oxidase inhibitor (MAOI) or has narrow angle glaucoma.
- Research shows that SSRIs (selective serotonin reuptake inhibitors) such as Paxil and Zoloft can help with sleep, overall well-being, and pain relief -- with lesser effects on fatigue and tender points from fibromyalgia. However, research indicates the SSRIs aren’t as effective as the SNRIs in treating fibromyalgia.
- Amitril, Elavil, and other tricyclic antidepressants are often prescribed for fibromyalgia, but many people don't like their side effects (weight gain, dizziness, fatigue). At low doses, these medications don't help mood or anxiety disorders, which fibromyalgia patients often have. However, this type of antidepressant can help with sleep.
Treating Insomnia From Fibromyalgia
- A low-dose tricyclic antidepressant (like Amitril) can help improve deep, restorative sleep.
- A prescription sleep medication like Ambien, Lunesta, Rozerem and Sonata is not addictive in low doses. These are called "short-acting" drugs because they stay active in the body for the shortest amount of time. Each of these drugs works a bit differently. Some help people fall asleep more quickly; others make sure you stay asleep.
- The anticonvulsant drug, Lyrica, is also prescribed for insomnia and fatigue caused by fibromyalgia.
- In small studies, the narcolepsy drug Xyrem has been reported to help both sleep and pain. Xyrem is a potent sleep medication that helps patients get the deep sleep they need.