Posted by MERM on 2/21/2009, 11:24 am
Fibromyalgia Medications
There are many different medications used to treat fibromyalgia symptoms, including sleeping pills and antidepressants. Some fibromyalgia medicines help ease pain. Others boost mood and improve sleep. Working with your doctor will help you find the right fibromyalgia medication to add to your treatment regimen. That way, you can manage your symptoms effectively.
The FDA has approved three drugs to treat fibromyalgia: Lyrica, Cymbalta, and Savella. Lyrica is an anti-epileptic drug. Cymbalta is an antidepressant known as a serotonin and norepinephrine reuptake inhibitor (SNRI). Savella is also an SNRI.
What's the first-line therapy for fibromyalgia?
About three out of every 10 people with fibromyalgia also have depression and/or anxiety. As a result, doctors frequently prescribe antidepressants that boost mood, ease pain, and improve sleep. In fact, tricyclic antidepressants and the muscle relaxant cyclobenzaprine (Cycloflex, Flexeril) are often used first for fibromyalgia.
How do tricyclic antidepressants treat fibromyalgia symptoms?
The tricyclic antidepressants, including Elavil and Pamelor, work by raising the levels of neurotransmitters in the brain. When the tricyclic antidepressants are prescribed in low doses, they often help improve the quality of sleep.
Tricyclic antidepressants increase levels of serotonin and norepinephrine in the brain. Patients with chronic pain often have decreased levels of these calming neurotransmitters. Tricyclics can relax painful muscles and heighten the effects of endorphins -- the body's natural painkillers. On the other hand, tricyclic antidepressants may cause drowsiness, dizziness, dry mouth, dry eyes, and constipation.
Do other antidepressants give relief of pain and fatigue?
The selective serotonin reuptake inhibitors (SSRIs) are one of the newer classes of antidepressants.
These fibromyalgia drugs include Prozac, Zoloft, and other antidepressants. They block the reuptake of serotonin and allow more serotonin to travel from neuron to neuron. That results in improved mood.
Increased amounts of serotonin may also help to ease pain and reduce fatigue. Because SSRIs may interfere with sleep, some fibromyalgia specialists prescribe SSRIs with a tricyclic antidepressant to increase restful sleep.
Which fibromyalgia medications help relieve the pain?
Different types of analgesics or painkillers are sometimes recommended to ease the deep muscle pain and trigger-point pain that comes with fibromyalgia. The problem is these analgesics don't work the same for everyone with fibromyalgia.
The over-the-counter pain reliever acetaminophen (Tylenol) elevates the pain threshold so you perceive less pain. Aspirin blocks the production of prostaglandins, the chemicals in the body that cause pain, inflammation, and swelling.
Nonsteroidal anti-inflammatory drugs (NSAIDs), when taken alone, haven't been shown to relieve pain in fibromyalgia. However, when combined with other fibro medicines such as Elavil, Flexeril, or an SSRI, NSAIDs often do help. NSAIDs are available over the counter and include drugs such as aspirin, ibuprofen (Advil), and naproxen (Aleve).
People with fibromyalgia also get the "regular" pains of life. They get menstrual cramps, muscle sprains and strains, and headaches. NSAIDs and Tylenol can be effective for these everyday pains in people with fibromyalgia.
Are there side effects with pain relievers for fibromyalgia?
Be careful taking aspirin or other NSAIDs if you have stomach problems. These medications can lead to heartburn, nausea or vomiting, stomach ulcers, and gastrointestinal bleeding. They can also increase clotting time.
Aspirin and other NSAIDs can cause or exacerbate peptic ulcer disease (ulcers of the stomach or intestine). If you've had ulcers or any kind of gastrointestinal bleeding, talk to your doctor before taking NSAIDs. Acetaminophen is relatively free of side effects. But avoid this medication if you have liver disease.
Some people cannot take aspirin or NSAIDs because of what's known as the aspirin/nasal polyp triad. Although uncommon overall, this aspirin sensitivity occurs in about 10% to 15% of people with asthma.
Among people with asthma and nasal polyps the rate of occurrence is 30% to 40%. If you have aspirin sensitivity, you might have symptoms such as itching, rashes, hives, swelling, nasal congestion, and wheezing.
Talk to your doctor about alternative therapies for resolving fibromyalgia pain if you have this sensitivity.
Are muscle relaxants helpful for fibromyalgia pain?
The muscle relaxant cyclobenzaprine (Cycloflex, Flexeril) has proved useful for the treatment of fibromyalgia. It's often prescribed to help ease muscle tension and improve sleep
. Muscle relaxants work in the central nervous system to relax skeletal muscles. They are also used to ease pain problems associated with fibromyalgia, including TMJ, headache, muscle pain, and other aches and pain.
With muscle relaxants, you may experience dry mouth, dizziness, drowsiness, blurred vision, clumsiness, unsteadiness, and change in the color of your urine.
These medications may increase the likelihood of seizures. Older adults sometimes experience confusion and hallucinations when taking them.
When are anticonvulsants used for fibromyalgia?
Lyrica is a newer drug for treating fibromyalgia. This anti-epileptic or anticonvulsant drug slows down impulses in the brain that cause seizures. With fibromyalgia, Lyrica affects chemicals in the brain that send pain signals across the nervous system. So it reduces pain and improves sleep.
Lyrica is the first drug to be approved by the FDA specifically for treating the symptoms of fibromyalgia. Gabapentin (Neurontin) is an anticonvulsant medication that is being studied for use in people with fibromyalgia.
Other anticonvulsants are often used to treat related pain such as TMJ, nerve pain, migraines, and myofascial pain. These medications work by decreasing substance P activity and stabilizing neuronal activity in the brain at high doses.
Are there other fibro pain medications available?
Non-narcotic analgesics such as Ultram -- a stronger analgesic than acetaminophen -- are commonly used to treat fibromyalgia. This narcotic-like medication acts centrally in the brain to modulate the sensation of pain. It has no anti-inflammatory effect, however, and is not as addictive as narcotics.
In addition, many doctors prescribe benzodiazepines such as Klonopin, Xanax,Ativan, and Valium to help relax painful muscles, improve sleep, and relieve symptoms of restless legs syndrome (unpleasant sensations in the legs that force you to move them constantly). These medications act to depress the central nervous system. The result is sedation, hypnosis, skeletal muscle relaxation, anticonvulsant activity, and sometimes coma in large doses. Benzodiazepines are addictive and must be used with caution on a short-term basis.
Powerful opioid pain medications, such as OxyContin, should only be considered if all other drugs and alternative therapies have been exhausted and there is no relief webmd wellnesstrainpostedby MERMIE
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