Are There Good Medications To Treat Fibromyalgia?

There are plenty of medication options for the treatment of fibromyalgia, however, a lot of them simply do not work and are not FDA approved. Whether or not a medication is FDA approved is not necessarily a litmus test for success. In addition, even if the medication is FDA approved for one indication, they can successfully be used many times off label for other conditions.

Fibromyalgia is an extremely difficult disease to treat. Many doctors treat it with opiates because it does cause diffuse pain and innately one would think it beneficial for fibromyalgia. Interestingly there is a lot of evidence now that narcotics actually may make the situation worse for fibro patients. This is known as opioid induced hyperalgesia. Chronic opioid medication usage that makes a fibromyalgia patient worse is not a great option.

In addition, we know that chronic usage of opioid medications represents a poor choice for most patients. Chronic pain medications may cause a patient to become depressed, they may cause constipation, they may cause addiction, and eventually they can cause a significant withdrawal if a patient decides they want to just get off of the medication.

Tramadol is one medication that has been shown to be very helpful for fibromyalgia patients. The trade name is Ultram, and it is a non-narcotic analgesic. It has dual action, one being tricyclic activity, which blocks the release of epinephrine and serotonin, and on top of that it has opioid agonist activity. This double mechanism of action works really well for fibromyalgia people.

Another medication class that can be beneficial for fibro patients is tricyclic antidepressants. These include medications like cyclobenzaprine, amitriptyline, and nortriptyline. These were not originally indicated for fibromyalgia but a number of recent studies have shown benefits.

One of the FDA approved medications for fibromyalgia is milnacipran. In the US, it is an approved medication for fibro. The side effects of the medication are similar to another fibro medication called duloxetine. Milnacipran is typically combined with pregabalin for treatment.

A second FDA approved medication for fibromyalgia is duloxetine. It has achieved FDA approval in the US for depression, anxiety, and painful diabetic neuropathy. The medication is called an SNRI – serotonin and norepinephrine reuptake inhibitor. One of the common side effects with duloxetine is nausea, with otherse being sleepy or even insomnia.

The third medication that is FDA approve for fibromyalgia is called pregabalin. The brand name is Lyrica. This medication was initially FDA approved for painful diabetic neuropathy, epilepsy, and postherpetic neuropathy. Side effects that can be seen with pregabalin are swelling in the extremities, dizziness, and drowsiness. It is not clear why pregabalin works, but significant research has shown great results.

Thankfully, now better medication options exist for fibromyalgia patients.

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