Posted by merm on 3/26/2009, 5:45 am
Medications are one way you can gain some control over your symptoms.
They may enable you to handle a greater amount of bodywork and exercise, and can be used to restore greater levels of function.
Until recently, much of the medical world regarded complaints caused by FMS and CMP as psychological. One result of that attitude is that very few drugs are established as effective in these conditions. Medications developed for other conditions may often prove helpful.
Antidepressants have pain-relieving effects independent of changes of mood, for example, and in lower doses than used to treat depression (Fasmer, 1990) and may be effective in reducing pain associated with FMS (Fishbain, 2000).
Medication should never be considered as the only form of pain control.
It must be part of a global strategy, with
sound nutrition,
bodywork,
mindwork,
lifestyle adjustments,
and other non-medicinal options of pain control.
Before adding any new medication, review your current meds with your doctor. Discuss your options.
Address all perpetuating factors.
For example, you may have been put on
Tagamet,
Zantac
or Prilosec for heartburn and esophageal reflux.
NOTE FROM MERM: I AM ON ZANTAC BUT I ONLY TAKE I WHEN I NEED IT. NEVER DAILY OR REGULARLY AND I WATCH WHAT I EAT
These can decrease your ability to digest foods, and add to your symptoms in the long run.
If you have reflux, look into the possibility that you may have insulin resistance/reactive hypoglycemia.
NOTE: YEARS AGO I HAD SEVERE HYPOGLCEMIA. IT STILL REOCCURS IF I DO NOT WATCH MY DIET JUST AS IT DOES A DIABETIC
If you crave carbohydrates and have other symptoms of these conditions, try diet modification.
Eliminate excess carbohydrates.
Check for possible TrPs in the area around the base of your breastbone.
With a change of diet and some myotherapy, you may be able to avoid these expensive medications.
Medications that affect the central nervous system are appropriate for FMS.
These meds target insomnia, pain, and fatigue.
Pain sensations are amplified by FMS, so if you have TrPs or other instigators, your total pain level may be severe.
FMS patients may react in an unusual manner to medications.
Keep careful records of your medicines using a medical use form such as the one in "The Fibromyalgia Advocate".
There is no cookbook recipe for prescribing medications for FMS and CMP.
A medication that works well for one person can be completely ineffective for another.
It is important that you don’t mix nonprescription medications, such as herbal remedies, with your prescription medications without discussing it with your health team first.
Over the Counter (OTC) Medications and Supplements
Benadryl (diphenhydramine): This sleep aid/antihistamine is safe to take even during pregnancy. The starting dose is 50 mg, taken 1 hour before bed. About 20 percent of patients are stimulated rather than sedated by Benadryl. Patients have reported urinary hesitancy on this medication.
Calms Forte: This mix of herbs and minerals may be effective to promote sleep.
Chromium Picolinate: This may decrease carbocraving. It seems to improve the efficiency of insulin (Striffler, Law, Polansky et al. 1995).
Coenzyme Q10 is a vitamin-like substance. Some people have found it helps reduce fibrofog. It’s an important part of the mitochrondrial membrane, but we don’t understand its functions.
DHEA (dehydroepiandrosterone) turns into estrogen and testosterone in your body. High doses (25-50 mg/daily) can trigger heart irregularities, or even a heart attack. (Sahelian and Borken, 1998). Some FMS patients report it helps them feel better.
Digestant Enzymes: If you have problems digesting foods, try taking papain or a natural enzyme combination to help your gastrointestinal system break down foods.
Glucosamine and chondroitin: These may be beneficial in cases of inflammation, bone or cartilage degradation, or problems with ground substance. Glucosamine may cause worsening of symptoms for FMS patients with high levels of hyaluronic acid
5-Hydroxytryptophan (5-HTP): Your body converts this to serotonin. It easily crosses the blood-brain barrier and effectively increases synthesis of serotonin (Birdsall, 1998).
Human Growth Hormone (HGH, somatotropin): This hormone is converted into insulin-like-growth-factor-1 (IGF-1). There are dangerous implications with OTC use (Ng, Ji, Tan et al.1998). The use of OTC growth hormone is not to be confused with the legitimate FMS research that has uncovered a subset of FMS patients who have low IGF-1. This deficiency occurs in about 30 percent of FMS patients (Bennett, 1998). Replacement treatment for these patients improves some FMS parameters.
Melatonin: Melatonin is a neurotransmitter that the body changes into serotonin. It may help reduce tender point count and severity of pain as well as improve sleep significantly in FMS patients (Citera, Arias, Maldonado-Cocco et al. 2000). Patients with FMS may have low melatonin secretion during the hours of darkness. This may contribute to poor sleep, fatigue, and enhanced pain (Wikner, Hirsch, Wetterberg et al. 1998). Melatonin in sufficient dosage may inhibit ovulation. Up to one-third of those who try melatonin become depressed. If depression occurs, stop taking it immediately and alert your doctor. Melatonin should not be taken by people with autoimmune conditions (Lapin, Mirzaev, Ryzov et al. 1998). Melatonin may help reduce seizure-like symptoms.
NSAIDS: Nonsteroidal anti-inflammatory agents (NSAIDS) can be effective in cases of inflammatory pain, but neither FMS nor CMP are inflammatory. NSAIDs include medications such as aspirin, ibuprofen, acetaminophen and naproxen. NSAIDS have serious side effects including: asthma, cell toxicity; and chromosome abnormalities (Leach, Frank, Berardi et al. 1999). A large majority of the patients who develop serious GI complications on NSAIDS have never had previous mild side effects. Treatment with antacids and H2 receptor antagonists may increase the risk for subsequent serious GI complications (Singh, Ramey, Morfeld et al.1996).
Malic acid and magnesium: Malic acid plays a key part in the metabolism of carbohydrates, as well as in the formation of ATP. Magnesium and B6 are needed for malate to work in energy production (Lowe, 2000). One study showed that this combination is safe and may be beneficial in the treatment of FMS (Russell, Michalek, Fletchas et al. Abraham, 1995).
Prescription Medications
Pharmacies and Pharmacists
Have all your prescriptions filled at one pharmacy so your pharmacist can warn you of any possible drug interactions, no matter how many doctors you have.
Your pharmacist can be a great ally and teacher. Learn about your medications. Develop a working relationship based on mutual respect and trust. Educate your pharmacist about FMS and CMP. The handout "What Your Pharmacist Should Know" from The Fibromyalgia Advocate may be helpful. If your pharmacist treats you like a drug addict or malingerer, let him/her know that this is inappropriate, and that you do not allow inappropriate behavior from health care providers.
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