Food and Drug Administration has approved three drugs for the treatment of fibromyalgia. They include two drugs that change some of the brain chemicals serotonin and norepinephrine that help control pain levels: duloxetine Cymbalta and milnacipran Savella. Older drugs that affect these same brain chemicals also may be used to treat fibromyalgia. These include amitriptyline Elavil and cyclobenzaprine Flexeril. Other antidepressant drugs can be helpful in some patients. Side effects vary by the drug. Ask your doctor about the risks and benefits of your medicine.
The other drug approved for fibromyalgia is pregabalin Lyrica. Pregabalin and another drug, gabapentin Neurontin , work by blocking the over activity of nerve cells involved in pain transmission. These medicines may cause dizziness, sleepiness, swelling and weight gain. It is strongly recommended to avoid opioid narcotic medications for treating fibromyalgia. The reason for this is that research evidence shows these drugs are not of helpful to most people with fibromyalgia, and will cause greater pain sensitivity or make pain persist.
Tramadol Ultram may be used to treat fibromyalgia pain if short-term use of an opioid narcotic is needed. Over-the-counter medicines such as acetaminophen Tylenol or nonsteroidal anti-inflammatory drugs commonly called NSAIDs like ibuprofen Advil, Motrin or naproxen Aleve, Anaprox are not effective for fibromyalgia pain. Yet, these drugs may be useful to treat the pain triggers of fibromyalgia. Thus, they are most useful in people who have other causes for pain such as arthritis in addition to fibromyalgia.
For sleep problems, some of the medicines that treat pain also improve sleep. These include cyclobenzaprine Flexeril , amitriptyline Elavil , gabapentin Neurontin or pregabalin Lyrica. It is not recommended that patients with fibromyalgia take sleeping medicines like zolpidem Ambien or benzodiazepine medications. Even with the many treatment options, patient self-care is vital to improving symptoms and daily function. In concert with medical treatment, healthy lifestyle behaviors can reduce pain, increase sleep quality, lessen fatigue and help you cope better with fibromyalgia.
With proper treatment and self-care, you can get better and live a more normal life. Here are some self-care tips for living with fibromyalgia:. Fibromyalgia is not a form of arthritis joint disease. It does not cause inflammation or damage to joints, muscles or other tissues.
However, because fibromyalgia can cause chronic pain and fatigue similar to arthritis, some people may advise you to see a rheumatologist. As a result, often a rheumatologist detects this disease and rules out rheumatic diseases. For long term care, you do not need to follow with a rheumatologist. Your primary care physician can provide all the other care and treatment of fibromyalgia that you need.
The American College of Rheumatology has compiled this list to give you a starting point for your own additional research.
The ACR does not endorse or maintain these websites and is not responsible for any information or claims provided on them. It is always best to talk with your rheumatologist for more information and before making any decisions about your care. Updated March by Isabelle Amigues, M. This information is provided for general education only. Individuals should consult a qualified health care provider for professional medical advice, diagnosis and treatment of a medical or health condition. Do you need help? Call Help Get more information. Fibromyalgia Fast Facts Fibromyalgia affects two - four percent of people, women more often than men.
Fibromyalgia is not an autoimmune or inflammation based illness, but research suggests the nervous system is involved.
Treatment of fibromyalgia - NPS MedicineWise
There is no test to detect this disease, but you may need lab tests or X-rays to rule out other health problems. Though there is no cure, medications can reduce symptoms in some patients. Patients also may feel better with proper self-care, such as exercise and getting enough sleep. Simple analgesia is often the first medication patients with fibromyalgia will trial. Guidelines published by the European League Against Rheumatism EULAR recommend the use of simple analgesics like paracetamol in the management of fibromyalgia; however, due to insufficient data this is based on expert opinion alone.
Women with fibromyalgia syndrome in New Zealand: the symptom experience
Other opioid use in fibromyalgia is not routinely recommended. There is reduced opioid receptor availability in patients with fibromyalgia, 36 and a lack of supportive evidence for their efficacy. The use of non-steroidal anti-inflammatory agents NSAIDs has not been supported with significant research data, however they are often used and a survey of patients with fibromyalgia, found that Medications that elevate levels of serotonin and noradrenaline in the descending inhibitory nociceptive pathways of the CNS, such as low-dose tricyclic antidepressants TCAs and serotonin-noradrenaline reuptake inhibitors SNRIs , can provide significant benefit in patients with fibromyalgia independent of effects on mood.
Pregabalin and gabapentin bind to voltage-dependent calcium channels, reducing calcium influx into sensitised spinal cord neurons in central pain syndromes such as fibromyalgia. In a meta-analysis of randomised, controlled trials in fibromyalgia patients, the use of these agents resulted in reduced pain, improved sleep and better quality of life.
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Asthma control in general practice GP and patient perspectives compared.
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Diagnostic challenges October Fibromyalgia Volume 42, No.
Pain: Clinical Updates
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