Disclaimer: The information in this post is for you to understand the types of medication used to treat fibromyalgia symptoms. Every person’s body is different, and you need to consult a doctor about your symptoms. Only your doctor can choose the correct medication for you.
Since doctors don’t know what causes fibromyalgia, there aren’t any medications to treat specific cause/s. Instead fibromyalgia treatments are aimed at the person’s symptoms. I’ll start with the medications that are currently used, then in the next post go on to alternative therapies that many fibro warriors find helpful.
Medications for Fibromyalgia Treatment
First of all not everyone responds the same to medications. What helps one person may not help another or may cause unacceptable side effects. People with fibromyalgia are often very sensitive to medications. You need to find a doctor who is knowledgeable in fibromyalgia and its treatment who will work with you to find the medications and doses that work for you. It will be a trial and error process. Medications for fibro fall into these categories: Pain killers, drugs for nerve pain, antidepressants, muscle relaxers or anti-spasmodics, anti-anxiety meds, medications for sleep disorders/fatigue.
1. Pain Killers
- Pain killers, also called analgesics. These include over-the-counter pain relievers, and prescription pain medications.
Since fibromyalgia is not really an inflammatory disease, anti-inflammatory medications like Motrin, or Aleve, may or may not help. If you’re experiencing an inflammatory thing like costochondritis, where your rib cage is very sore with movement, these medications will help. Tylenol or acetaminophen can relieve minor pain or headaches. Be careful to follow the dosing instructions for over-the-counter pain medications to prevent stomach ulcers, or liver damage.
According to Health Central’s article Medications Prescribed For Fibromyalgia:
"Recent studies have indicated that opiate pain medications often do not relieve FM pain. It appears that the mu-opioid receptors in people with fibromyalgia have a reduced ability to bind to the drugs targeting them. There is also emerging evidence that over the long term, the use of high-dose opioids may actually increase an FM patient's hypersensitivity to pain." Health Central
Depending on the severity of your pain, they may help get it under control. You may be able to lessen the dose or get off of it once your pain settles down. What you can do is start with lower doses, and see how they work. Then adjust as needed.
Tramadol is a synthetic opiod medication that works differently than Percocet or oxycodone. I do get pain relief from it, but my son with fibromyalgia does not.
2. Drugs For Nerve Pain
2. Anti-convulsant drugs, like Lyrica and Neurontin.
Lyrica is the first FDA approved treatment for fibromyalgia. It works by calming down pain signals in the brain.
In clinical trials, Lyrica reduced pain and improved sleep, fatigue and general health perception in 30 to 40 percent of FM patients.
Neurontin has been helpful for nerve pain, like burning, tingling, and zapping sensations.
3. Antidepressants for Fibromyalgia Treatment
3. Antidepressants especially the serotonin and norepinephrine reuptake inhibitors (SNRIs).
At first when my doctor wanted to order an antidepressant for my fibro pain, I was a bit offended, as if he thought it was just a mental disorder. However, I was wrong about that. According to this Health Central article, “Antidepressants are often among the first treatment options tried for fibromyalgia patients because they can improve sleep, reduce pain and help mood disturbances.”
I was taking Tramadol at bedtime to help with pain so I could fall asleep, and stay asleep longer. When my doctor ordered Wellbutrin, my pain improved so much that I didn’t need the tramadol except for flare episodes. So if your doctor wants you to try an antidepressant go for it.
The two FDA approved antidepressants for fibromyalgia are Cymbalta, and Savella. Antidepressants work by improving brain chemical levels, like serotonin, and norepinephrine. These brain chemicals are low in people with fibromyalgia. Another one is Remeron, which helps with sleep. I had to stop using this, because it made me so dizzy I was afraid of falling.
4. Muscle Relaxers or Anti-Spasm Meds
4. Muscle relaxers and anti-spasm medications.
“Muscle relaxants like Flexeril, Soma, Skelaxin and Robaxin are sometimes prescribed for fibromyalgia pain.” Health Central They appear to reduce muscle pain. This might be a good choice if your muscles are very sore. If you’re having muscle spasms, a medication like Zanaflex can block pain and reduce spasms. Zanaflex also helps with sleep and preventing headaches.
5. Anti-Anxiety Medication
5. Anti-anxiety medications like, klonopin, ativan, and zanax.
Being in intense pain makes one anxious. The more anxious we get, the tenser our muscles become which leads to more pain. If you’re suffering from intense anxiety as well as intense pain, you may need an anti-anxiety medication to help stop the cycle. This isn’t because of any weakness or failure on your part. Anxiety is a natural response to pain. It’s meant to lead you to get help for the pain. So you can see that chronic pain can lead to chronic anxiety. There is no shame in needing medication when your anxiety is out of control.
“They work by improving the balance of inhibitory and excitatory receptors in the central nervous system. (Most FM patients have too much activity in their excitatory receptors.) Klonopin taken in the evening can be particularly helpful for patients who have a lot of leg problems, including pain and restless or jerking legs.”Health Central
If you have restless, jerking legs at night, I have found that Magnilife Restless Legs Cream works wonders for me. I get mine at Rite Aid Pharmacy. They’ve recently changed the name to Relaxing Leg Cream.
6. Medications For Sleep and Fatigue
6. Medications for sleep like Restoril, Ambien, Lunesta, and Rozerem.
Getting a good night’s sleep is an elusive dream for most fibromyalgia warriors. If your pain is fairly well controlled, but you’re still having trouble sleeping talk to your doctor. There are medicines to help you fall asleep, and treatments for things like sleep apnea, restless leg syndrome, narcolepsy, etc.
In a 2006 study, they used a drug called Provigil to see if it would help the fatigue in fibro patients. “Two-thirds of the fibromyalgia patients taking Provigil experienced a 50 percent reduction in fatigue levels.” Health Central
So this might be something to try if your fatigue is debilitating and you need to be alert for work or parenting young children.
7. Low-Dose Naltrexone-Off Label Use
7. An off-label medication shortened to LDN.
Lastly, Naltrexone is a medication used to treat alcohol and opiod addiction. “Low-dose naltrexone (LDN) has shown promise to reduce symptoms related to chronic pain conditions such as fibromyalgia, inflammatory bowel conditions, and multiple sclerosis.” At a low dose this drug has been a helpful pain reliever for people with “fibromyalgia, inflammatory bowel conditions and multiple sclerosis.” Some pain management doctors have been prescribing this medication.
My son has found that this helps his fibro pain without side effects. I started using LDN in August 2023, and it reduced a whole summer-long flare to pre-flare levels. It’s become a vital part of my fibro tool box. I experienced more vivid dreams when I first started taking it, but this quickly went away. I haven’t noticed any other side effects.
You can read more about LDN here: https://pubmed.ncbi.nlm.nih.gov/32845365/
Wrap- Up of Fibromyalgia Treatments
The information in this post came from an article on Health Central called Medications Prescribed For Fibromyalgia. It was written by Karen Lee Richards, who is the co-founder of the National Fibromyalgia Association.
The cost of medications can keep us from being able to use them. Check out The Ultimate Guide to Drug Discounts to learn how you may be able to afford your medicines.
If you missed my previous post about the proposed causes of Fibromyalgia, you can read it here: https://www.upbeatliving.net/fibromyalgia-causes-current-ideas/
This wraps up the medications used to help manage fibromyalgia symptoms. The next post will discuss alternative treatments that many have found to be very beneficial for their fibro. Finally, please do not go into a doctor’s appointment and ask about a specific drug unless you have an established relationship with your doctor. Some doctors, especially emergency room docs, will think you’re a drug seeker if you request a specific pain medication. Till next time, Kathy
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