Fibromyalgia Medications

There are many different medications used to treat fibromyalgia symptoms, including sleeping pills and antidepressants.  Some fibromyalgia medicines help ease pain. Others boost mood and improve sleep. Working with your doctor will help you find the right fibromyalgia medication to add to your treatment regimen. That way, you can manage your symptoms effectively.

The FDA has approved two medications to treat fibromyalgia: the anti-epileptic drug Lyrica and the antidepressant Cymbalta.

What's the first-line therapy for fibromyalgia?

About three out of every 10 people with fibromyalgia also have depression and/or anxiety. As a result, doctors frequently prescribe antidepressants that boost mood, ease pain, and improve sleep. In fact, tricyclic antidepressants and the muscle relaxant cyclobenzaprine (Cycloflex, Flexeril) are considered to be first-line therapy for fibromyalgia.

How do tricyclic antidepressants treat fibromyalgia symptoms?

The tricyclic antidepressants, including Elavil and Pamelor, work by raising the levels of neurotransmitters in the brain. When the tricyclic antidepressants are prescribed in low doses, they often help improve the quality of sleep.

Tricyclic antidepressants increase levels of serotonin and norepinephrine in the brain. Patients with chronic pain often have decreased levels of these calming neurotransmitters. Tricyclics can relax painful muscles and heighten the effects of endorphins -- the body's natural painkillers. On the other hand, tricyclic antidepressants may cause drowsiness, dizziness, dry mouth, dry eyes, and constipation.

Duloxetine (Cymbalta) has been approved by the FDA to treat fibromayalgia. It gives relief for fibromyalgia pain and also eases other symptoms.

Do other antidepressants give relief of pain and fatigue?

The selective serotonin reuptake inhibitors (SSRIs) are one of the newer classes of antidepressants. These fibromyalgia drugs include Prozac, Zoloft, and other antidepressants. They block the reuptake of serotonin and allow more serotonin to travel from neuron to neuron. That results in improved mood.

Increased amounts of serotonin may also help to ease pain and reduce fatigue. Because SSRIs may interfere with sleep, some fibromyalgia specialists prescribe SSRIs with a tricyclic antidepressant to increase restful sleep.

Which fibromyalgia medications help relieve the pain?

Different types of analgesics or painkillers are sometimes recommended to ease the deep muscle pain and trigger-point pain that comes with fibromyalgia. The problem is these analgesics don't work the same for everyone with fibromyalgia.

The over-the-counter pain reliever acetaminophen (Tylenol) elevates the pain threshold so you perceive less pain. Aspirin blocks the production of prostaglandins, the chemicals in the body that cause pain, inflammation, and swelling.

Nonsteroidal anti-inflammatory drugs (NSAIDs), when taken alone, haven't been shown to relieve pain in fibromyalgia. However, when combined with other fibro medicines such as Elavil, Flexeril, or an SSRI, NSAIDs often do help. NSAIDs are available over the counter and include drugs such as aspirin, ibuprofen (Advil), and naproxen (Aleve).

People with fibromyalgia also get the "regular" pains of life. They get menstrual cramps, muscle sprains and strains, and headaches. NSAIDs and Tylenol can be effective for these everyday pains in people with fibromyalgia.