In the day and age of the internet, there are thousands of valuable resources at your fingertips. The same applies to treatment of fibromyalgia.
Gone are the days when you would sit back and just rely solely on your doctor’s recommendations.
Now, doctors appreciate if you have questions and perhaps even better alternatives that may suit your conditions.
It is for this reason that we must know which medication is available out there that will suit your symptoms of fibromyalgia for your particular case.
Symptoms can vary amongst individuals
Fibromyalgia, a disease that consist of wide spread muscle and joint pain, anxiety, insomnia or even depression, affects more than 3 million people in the United States per year.
With such wide spread symptoms, not only do an array of medications need to be used but also the ones that have the least side effects.
It is common knowledge that different people react to a certain medication differently. The relief or side effect one person might experience, the other may not.
It is for this reason that Fibromyalgia therapy should be designed according to the individual person and for their own requirements.
Most doctors will look at your medication and medical history to narrow down to the drugs that best suit your needs.
This guide will help you know more about your medications and what to expect when you take them.
Have up to date information
This is extremely important. If you do not have complete information about your own ailment, how can you have a detailed conversation about your own needs?
With a chronic disorder like Fibromyalgia, we are talking about long term issues hence only with medication therapy designed specifically for you will you be able to gain the most relief.
Knowing what kind of new medical options are out there and even knowing the benefits or even side effects of different medications will help you talk to your doctor in detail and discuss your options.
Your options, simplified
When it comes to drug therapy, there are two main things that every person is concerned about: the benefits and the side effects of that medicine.
In this article, you will find the most commonly used medicines for fibromyalgia treatment broken down into sections that make it easier for you to understand the medicine at a glance!
Benefits and side effects – Pain medication
The most crucial aspect of fibromyalgia treatment is pain medication. The pain from this ailment makes everyday tasks extremely difficult hence the right medication will work wonders for this problem.
The biggest advantage to this drug when it comes down to pain relief is that it’s FDA approved. That tag alone means that it has passed through rigorous and quality tests via the food and drug administration and makes it relatively safe to use.
Lyrica is the most commonly prescribed drug used for pain when it comes to fibromyalgia.
Since fibromyalgia related pain is different from pain experienced by others, the way in which lyrica works is unexplained.
However, studies do indicate the lyrica the release of neurotransmitters in the brain consequently helping to control pain.
Lyrica can cause withdrawal symptoms if stopped abruptly. Dry mouth, constipation, flatulence and even dizziness are some of the bearable symptoms of Lyrica.
On the other hand, disturbance in muscle control and movement, insomnia, weight gain and even visual disturbances are side effects that add further difficulty to patients suffering from fibromyalgia.
If you do experience such side effects, it may be a good idea to consult your doctor or about moving to another painkiller.
Cymbalta (duloxetine hydrochloride)
Cymbalta became is the second drug to be approved by the FDA for the treatment of Fibromyalgia related pain in 2008.
This medicine works the same way as Lyrica does and is also used for people suffering from depression.
Interestingly, various anti-depressants have shown positive effects in the treatment of fibromyalgia and is on top of the list as the most well studied option.
Studies indicate that a substantial number of people using Cymbalta for fibromyalgia related pain have received good pain relief.
The use of Cymbalta can induce side effects like nausea, dry mouth, sleepiness, constipation, decreased appetite, and increased sweating which are common with most drugs.
Other side effects include risks of suicidal thinking (patients who suffer from depression), fatigue, tachycardia (increased rate of heart beats), taste disturbance and cold extremities.
Another FDA approved drug formulated specifically for the treatment of fibromyalgia, Savella has proven to be useful for many patients who experience pain.
With the same mechanism of action as many antidepressants, Savella is still not used to treat depression but only used for fibromyalgia.
Other than treating the pain associated with fibromyalgia, Savella also aids in the reduction of fatigue associated with the same disorder.
Agitation, hallucinations, muscle twitching, sweating or fever, stiff muscles, dizziness, or diarrhea are some of the important side effects of the use of Savella.
Itching, right upper-belly pain, dark urine, yellow skin or eyes, or unexplained flu-like symptom should also be looked out for as they may indicate liver issues caused by Savella.
Although not specially designed for Fibromyalgia pain like Cymbalta, Gabapentin has been studied and has shown benefits.
A study conducted showed that 4 out of 10 people experienced a reduction of their pain by at least half1.
Even though Gabapentin was originally formulated to treat epilepsy, it has since been used to treat various forms of chronic pain.
Like with other medications, gabapentin induces nausea, vomiting, gingivitis (dental disorder of the gums), diarrhea, and even abdominal pain.
Some people have also been known to have allergic reactions to Gabapentin like hives or difficulty breathing. If you experience any of these symptoms or skin rashes, contact your doctor immediately.
Benefits and side effects – medication for pain, sleep disturbances and fatigue
For this category, most commonly, antidepressants are used as they can target pain, sleep disturbances and even fatigue.
Categories like tricyclic antidepressants and Selective serotonin reuptake Inhibitors (SSRIs) are used.
Fluoxetine is prescribed at doses lower than the ones used to treat depression where they promote the release of serotonin (the feel-good neurotransmitter) and reduce fatigue, and even pain.
Some studies have shown combining fluoxetine and amitriptyline (another antidepressant) was twice as effective than just using either medication alone2.
Fluoxetine can cause diarrhea, hypotension (drop in blood pressure), taste disturbance and confusion.
Constipation is another side effect of this drug and consequently a higher intake of fiber might have to be recommended to avoid this effect.
Some antibiotics have been known to interact with fluoxetine so make sure you give your doctor your complete history before starting on any dew drugs.
Elavil (Amitriptyline hydrochloride)
A tricyclic antidepressant, Amitriptyline has been shown to be quite beneficial when it comes to various symptoms of fibromyalgia.
The benefits are comparatively less when used alone than when in combination with Prozac (see above).
Used at a much lower dosage than when used for depression, Amitriptyline has been in use for years for fibromyalgia.
Like with other antidepressants, some side effects are to be expected when it comes to using them.
People with heart issues should steer clear of this medication as it has a history of causing arrhythmias (irregular heartbeats) or even heart block.
Furthermore, elderly patients have been known to experience side effects like anxiety, agitation, confusion, or even irritability.
Some patients have also experience hypertension (increased blood pressure), fatigue, or even abdominal pain.
Commonly used drugs that may help with pain
There are some commonly used drugs that can be found over the counter (OTC) that have shown slight benefit when it comes to pain relief.
Although prescription medications have shown the most effects, for some people even OTC medications may be very beneficial.
Studies have shown than no one particular drug can completely alleviate fibromyalgia related pain however, drugs like Tylenol have a lower threshold of side effects and also help with the symptoms.
Although not completely known how, Tylenol has been known to take away effects of pain and fatigue.
Due to the ease of availability and lower threshold of side effects, it is easy to over dose on acetaminophen.
Also, acetaminophen is very commonly found as a combination medication in other drugs which may cause patients to overdose by taking both of them. Serious liver problems have been seen due to over dose of acetaminophen.
Some of the commonly seen side effects of acetaminophen over dose consist of nausea and vomiting, diarrhea, loss of appetite, confusion, sweating, extreme fatigue, unusual bleeding or bruising, abdominal pain, especially in the upper right portion, jaundice (yellow skin and eyes), flu-like symptoms and irregular heartbeat.
Narcotic Medications (opioids)
These medications are probably the most controversial when it comes to the treatment of Fibromyalgia.
Due to their high levels of addiction, doctors take extreme caution when turning to them for treatment.
However, studies and learned physicians indicate that with proper control and management, these narcotic painkillers can be incredibly beneficial when it comes to fibromyalgia related pain.
Interestingly, majority of the time, these narcotics will be found in combination with other drugs like acetaminophen (Tylenol etc.).
This is part of the reason why there is always a risk of over dosing with acetaminophen (see above).
Ultram (Tramadol Hydrochloride)
Benefits: A strong, prescription pain killer, tramadol is used for fibromyalgia related muscle pain. It has also been known to reduce flare-up pain, and reduce muscle spasms.
An added advantage to this drug is the availability of an extended release formulation which means that once ingested, the drug is slowly released into the blood over a longer period of time, thereby providing relief for chronic pain for 24 hrs.
Since Tramadol is a narcotic drug, it can be addictive. Also, some minor side effects like constipation, dizziness and drowsiness are part of the Tramadol chain.
Slightly more disturbing side effects like confusion, itching, breathing difficulties, or even fainting may occur with the ingestion of Tramadol.
Percocet (Oxycodone + acetaminophen)
Another effective narcotic, this combination medication provides pain relief in combination with acetaminophen.
This is another one of those medications that may lead to an over dose of acetaminophen however, with proper dose control and monitoring, it can be excellent for pain management.
The most common and feared side effect of this drug is the addiction effect, however, as mentioned above it can be avoided. Other effects consist of chills, dark urine, dizziness, fever, headaches, nausea, rashes or even loss of appetite.
Some of the rarely seen side effects consist of coughs with hoarseness, lower back or side pain, unusual bleeding or bruising.
Lastly, since it is common to over dose on this drug, it is beneficial to keep a look out for over dose symptoms like bluish lips, cold and clammy skin, extreme sleepiness, low blood pressure and slow breathing.
Vicodin (Hydrocone + acetaminophen)
This is another narcotic that has a fishy stigma amongst professionals. Although a significant number of fibromyalgia patients have seen benefits by using Vicodin, there are still those that use it for its “addictive” nature.
With the help and guidance of the right doctor, patients can use this drug for its pain relief benefits by starting at lower, controlled doses.
The major drawback for professionals and patients both is the fact that patients using Vicodin have difficulty leaving it. Apart from that, side effects of this dug consist of dizziness, light headedness, while drowsiness and sleepiness are quite common.
Symptoms of over dose due to usage consist of chest pain or discomfort, cloudy urine, increased sweating or even irregular heartbeat.
Lastly, due to the addition of acetaminophen in this combination, taking additional Tylenol is not advised as the risk of over dosing is significant.
Non-steroidal anti-inflammatory Drugs (NSAIDS)
Even though inflammation is not a symptom of fibromyalgia, NSAIDs have another action of pain relief which is what NSAIDs are used for.
These medicines work by inhibiting substances in the body called prostaglandins, which play a role in pain and inflammation.
These non- prescriptions or over the counter medication, may help ease the muscle aches of fibromyalgia.
They may also relieve menstrual cramps and the headaches often associated with fibromyalgia.
Interestingly, NSAIDs are not known to be beneficial on their own but have been quite useful when administered in combinations with narcotics.
As mentioned above, due to the classification as an NSAID, Meloxicam works by reducing hormones in the body that cause pain and inflammation.
When used in combination with other pain releasing drugs, it can be quite beneficial for fibromyalgia related pain.
Some of the rarely seen side effects of Meloxicam consist of Arm, back, or jaw pain, bleeding gums, bloating, blood in the urine, blurred vision, burning upper abdominal or stomach pain, canker sores, chest tightness or heaviness or even chills.
Allergic reactions have also been known to be associated with this drug. If you experience any skin rashes or hive like symptoms, notify your physician immediately.
Some of the commonly seen side effects of Meloxicam consist of diarrhea, stomach pain, anxiety, increased appetite, bloated feeling or even a change in taste.
Insomnia- a symptom associated with Fibromyalgia
Another symptom that can be incredibly disruptive for various people suffering from fibromyalgia is the problem of insomnia.
Characterized as a habitual problem in sleeping or sleeplessness, insomnia can eventually exacerbate other problems of fibromyalgia like fatigue and even pain.
Sometimes, insomnia can be a cause of an underlying symptom like restless lefs syndrome, sleep apnea or teeth grinding.
By treating insomnia, there may be some relief with the other symptoms. Various sleep aids are used for this issue, however, some of the commonly used medications are:
Ambien (Zolpidem Tartrate)
A prescription sleeping aid, Ambien can help sleep faster and has also been known to provide certain pain relief.
Zolpidem has some side effects associated with it that consist of diarrhea, nausea, vomiting, dizziness, headaches, hallucinations, agitation, amnesia and sometimes even depression.
This drug is also not recommended for long terms use as it may cause dependence.
Lastly, a major side effect is that it is very short acting. Some people who have used zolpidem have also reported less use of the drugs after some usage.
Gabapentin for chronic neuropathic pain and fibromyalgia in adults. https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0014677/
Goldenberg DL, Mayskiy M, Mossey C, Ruthazar R, Schmid C. A randomized, double-blind crossover trial of fluoxetine and amitryptyline in the treatment of fibromyalgia. Arthritis Rheum. 1996;39:1852–9.