Treating Fibro Pain: 5 Types of Medications Help

Discussion in 'Fibromyalgia Main Forum' started by JLH, Jan 17, 2010.

  1. JLH

    JLH New Member

    Treating Fibromyalgia Pain: Medication Options --
    5 Types of Medications Help Ease Fibromyalgia Symptoms.


    If pain is the primary fibromyalgia symptom, doctors may prescribe a prescription pain reliever, an anticonvulsant, or an antidepressant.

    Anticonvulsants, developed to treat seizures, help relieve many types of pain. Lyrica, an anticonvulsant, was the first medication approved by the FDA specifically for fibromyalgia pain.

    Two more antiseizure drugs are being studied as fibromyalgia medications -- Neurontin and Ativan.

    Antidepressants are very helpful in relieving fibromyalgia pain and improve deep restorative sleep. They work by balancing serotonin and other brain chemicals.

    • 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.
    Combination antidepressants: At times, a combination of antidepressants can help reduce muscle pain, anxiety, and depression in fibryomyalgia. Patients also get more restful sleep, feel less fatigue, and have an overall better sense of well-being.

    Pain relievers such as Ultram and Ultracet can help break cycles of fibromyalgia pain, relieve flare-up pain, and reduce muscle spasms. The muscle relaxant Flexeril can help reduce pain and improve sleep. Local injections of painkillers and/or cortisone at painful trigger points can be especially effective in breaking cycles of pain and muscle spasm.


    Insomnia is a big problem in people with fibromyalgia. Research shows that frequent disruptions in sleep prevent growth hormone -- the important restorative hormone -- from being produced by the body. Without growth hormone, muscles don't heal and neurotransmitters (like serotonin) are not replenished.

    Without deep sleep, the body can't recuperate from the day's stresses. This can overwhelm the body’s systems, creating a great sensitivity to pain.

    In some patients with fibromyalgia, there is an underlying cause for insomnia, such as restless leg syndrome or sleep apnea. If it's not clear what's causing the sleep problem, some doctors will prescribe one of several medications to help with sleep.

    • 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.
    Cope considers sleep aids to be a last resort. "We can give you medication for sleep, but we have to be careful," a doctor tells WebMD. "We don't want to take over the body's ability to produce neurochemicals -- or it will stop producing them."


    Chronic pain is tough to beat, so you need every bit of help you can get.

    Exercise boosts the body's natural production of serotonin (the mood-enhancing brain chemical). It also improves blood flow to muscles, releases stress and tightness, improves sleep, all of which helps relieve pain.

    Other lifestyle approaches also help with fibromyalgia. Stress reduction, relaxation techniques, prayer, yoga, visual imagery -- those help, too. Try different things. Find what works for you. These things will make a difference.

    But complete relief from fibromyalgia pain is not always possible. If your pain is moderate but you're living a normal life, going to work, you've made progress.

    Source: WebMD
  2. AuntTammie

    AuntTammie New Member

    Most of the article is an accurate summary of drugs commonly used for fibro, and it's interesting that they quote a Dr who says, "We don't want to take over the body's ability to produce neurochemicals -- or it will stop producing them." I have read about this happening, but many people do not know about it, bc most drug companies don't want them to I like that the article mentions this.

    However, it also says, "Two more antiseizure drugs are being studied as fibromyalgia medications -- Neurontin and Ativan." Ativan is an anti anxiety benzo; not an antiseizure drug and I have never read or heard of it being used off label for seizures, either......that is not to say that I know for sure that it is never used that way - it may be, but it certainly in not a common usage or the correct classification.
  3. pirtpain

    pirtpain New Member

    I take alot of meds I know but they have helped and I have experimented with several meds.
    During the daytime I take Savella, Wellbutrin, an antidepressant, Oxycontin for pain, Abilify for energy. At bedtime I take Neurontin for overactive nerve endings, Seroquel an anti-convulsant and Zanaflex a muscle relaxer. The evening meds also include Savella and Oxycontin. I know it's alot but I can finally function somewhat normally.

  4. JLH

    JLH New Member

    I'm on Neurontin, Cymbalta, and Zanaflex for fibro.

    I have tried dozens of antidepressants, and stayed with Cymbalta because it was also approved for diabetic neuropathy -- and I am a diabetic.

    I was on Neurontin for a long time, then wanted to try Lyrica. The Lyrica did not work for me--it kept me asleep all day! Couldn't stand that! So, I went back to Neurontin.

  5. wanderinbluedragon

    wanderinbluedragon New Member

    Unfortunately for me, I have tried almost all of the above meds..except for one or two and have had bad reactions to pretty much all of them.

    I have tried the generic form of Neurontin known as Gabbapentin and though I did not suffer too many side effects, there was almost no improvement in pain. Lyrica gave me terrible headaches and didn't help anyway.

    As for Ativan..I understood that this was a muscle relaxant not an anti-siezure drug.

    As for the endless amounts of anti-depressants, many of them have terrible side effects or have no effect at all. I took Cymbalta for several months and went in to my Doc one day with red rimmed, tired, dry eyes that I could barely keep open. I was listless, exhausted and it seemed to make all my Chronic Fatigue symptoms ten times worse..she immediately took me off the medicine and shot me full of B12 and took me off of work for a few days threatening to take me off for three months or more until I was able to function better.

    Effexor is about the only anti-depresant I was able to take and it did nothing for pain and had unwanted side effects as well. You also cannot take some of the older Tricyclic antidepressants with current anti-depressants.

    Ambien helped me stay asleep at night, but as usual, I never woke up feeling like I'd slept at all. Rozerem did not work at all.

    Ultram made me throw up as well as vicodin and neither did much for the pain..though I noticed that they make you care less about the pain..(that may not make sense but that's the best way I can describe it).

    I've also taken Provigil and low dose Aderall to help me be awake during the day and neither worked well either.

    As for the best part...trigger point injections...the pain you go through when you get these is terrible..they have to hurt you to find the trigger points..then inject those sore points with a needle filled with lidocaine, all though I believe they used a longer acting form on me called Marcaine (hope i spelled that correctly) and you have to practically jump out of your skin in pain for them to know when to inject the medicine. I would get four or five points done every three weeks and it would take two different appointments to get them all because my worse points are in the knee area and the elbow area and shoulders.

    This is one of those cases where I often have wondered if the cure is worse than the problem. It did provide relief for a few weeks and worked for longer when I first started getting the shots.

    Lidocain patches are good in theory too, but the medicine just doesn't get deep enough into the muscle to be of any help.

    I hope that others can obtain relief from some or all of these methods..I just haven't been able to. I keep hoping and waiting for something better to come along.

    I'd be willing to try Savella, but to be honest, I'm a bit scared of relying on another anti-depressant to do the job and just ending up with horrible side effects. It looks like progress is being made though on the Chronic Fatigue Syndrome front and if I can at least get one of these dxs under control, maybe the other wouldn't be so hard to take..

    Here's hoping


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