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 represents a very difficult disease process to treat. Because it causes pain in patients, many doctors feel that opioid medications should be beneficial for the treatment of fibromyalgia. What we now know is there is significant evidence showing that opioid medications actually may make patients’ pain with fibromyalgia worse. This concept is known as opioid induced hyperalgesia. Chronic usage of a medication such as opioids that may make the patients’ pain worse is probably not the best 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.
One medication that has actually shown to be of benefit in fibromyalgia patients is tramadol. Tramadol is a different kind of pain medication and is a non-narcotic analgesic. It has both tricyclic like activity, meaning it blocks the release of serotonin and epinephrine, and in addition also has opioid agonist activity. The dual mechanism of action has been shown to be fairly effective for fibromyalgia patients.
Another class of medications that can be very beneficial for fibromyalgia are tricyclic antidepressants. These include such medications as nortriptyline, amitriptyline, and cylobenzaprine. These medications were not originally indicated for fibromyalgia but numerous studies have shown that they do work fairly well.
One of the FDA approved medications for fibromyalgia is one call milnacipran. The medication is approved in United States by the FDA for fibromyalgia. The medication has side effects that are similar to another medication in this article called duloxetine. The medication is often combined with a medication like pre-Gabalin.
A second FDA approved medication for fibromyalgia is the duloxetine. This medication is also utilized in United States for anxiety, depression, and painful diabetic neuropathy. This medication is a serotonin and norepinephrine reuptake inhibitor. A common side effect for duloxetine is nausea. Another is being sleepy or paradoxically one can see insomnia.
The third FDA approved medications for fibromyalgia is called pregabalin. The brand name is better known as Lyrica. This medication was approved initially by the FDA for epilepsy, painful diabetic neuropathy, and postherpetic neuropathy. Side effects that can be seen with pregabalin are dizziness, drowsiness, and swelling in the extremities. It is not exactly clear why pregabalin works for fibromyalgia, but numerous studies have shown excellent results.
Thankfully, we now have better medication options for fibromyalgia patients.
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