The medications that are most effective for fibromyalgia are certain anti-epileptic drugs and antidepressants. This is not because patients like you have seizures or are always depressed, rather it is because of the way These drugs work on pain pathways in the brain and spinal cord. Specifically, both classes of drugs seem to work by reducing the pain impulses that reach the brain.
2 FDA approved drugs for fibromyalgia include Cymbalta© and Savella©. These drugs are from the anti-depressant class serotonin-norepinephrine re-uptake inhibitors or SNRI's. In clinical studies their side effects can sometimes include nausea, headache, dry mouth, fatigue, dizziness, constipation, increased heart rate, increased sweating and decreased appetite. Another drug, venlafaxine (generic Effexor, ©) is in this same class and has shown positive results in a few clinical trials, but is not FDA approved for fibromyalgia treatment.
Other antidepressants in different classes that have shown positive results in clinical studies include fluoxetine (generic Prozac©) and amitriptyline. Two particular drugs that have shown good results in the anti-epileptic class are Lyrica© and gabapentin (generic Neurontin ©). although Only Lyrica© is FDA approved for fibromyalgia in this class of drugs. Dizziness, fatigue and blurred vision are common side effects when first starting these drugs , but these side effects tend to rapidly improve. Other side effects that may lead to discontinuation of the drug include weight gain and leg swelling.
Additional medications may also be used based on a clinician's experience, including NSAID's such as Ibuprofen, muscle relaxers, and sleep aids. Patients often ask, "I'm in pain why can't I have pain medicines." There are several reasons: First, no study has shown traditional narcotics to be effective more than beyond a very short term. Second, in pain disorders caused by an abnormal central nervous system, narcotics can actually enhance pain over time.
Aerobic exercise, strength training, and stretching are activities which patients often report as being effective for the relief of fibromyalgia symptoms, but it is often useful to see physical therapist before starting a program. Also remember that fibromyalgia is not a destructive process, so physical activity may hurt but it does not do no harm.
Cognitive-behavioral psychotherapy teaches skills that change the way your mind influences your body and how you cope with pain. It is particularly helpful if you can consult with a psychologist who specializes in pain, but many self-help books and websites are available today to help in this type of therapy.
Acupuncture, massage and hypnosis have been used with success in many patients and many clinical studies have shown positive results. Enrolling and actively participating in Tai Chi has proven beneficial in a recent clinical study.
Over-the-counter supplements may be helpful in some patients but they have not shown consistently positive results in clinical studies. Special diets, such as a gluten-free diet, are reported by many patients to be very beneficial, but there is minimal scientific evidence to support this.
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