There are many different medications used to treat fibromyalgia symptoms, including pain medicines, 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.
Many people with fibromyalgia continue to work full or part time. But the chronic pain and fatigue associated with fibromyalgia often make working very difficult. If you are employed, it's important to learn about managing fibromyalgia symptoms and coping with pain and fatigue. In addition, if you have tried different jobs and are unable to work, you might consider applying for disability. Disability may be difficult to get, however, because of rules about work capacity.
The first medication doctors will often try for people with fibromyalgia is an antidepressant, which helps relieve pain, fatigue, and sleep problems. In addition, antidepressants help depression, which is commonly seen in people with fibromyalgia. Older antidepressants, called tricyclics, have been used for many years to treat fibromyalgia.
How do tricyclic antidepressants treat fibromyalgia symptoms?
The tricyclic antidepressants, including amitriptyline and nortriptyline (Pamelor), work by raising the levels of chemicals (neurotransmitters) in the brain.
Tricyclic antidepressants increase levels of serotonin and norepinephrine in the brain. People 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. While these medications are often very effective, the side effects can sometimes make them difficult to take, as they may cause drowsiness, dizziness, dry mouth, dry eyes, and constipation.
Do other antidepressants relieve the pain and fatigue of fibromyalgia?
There are several different types of antidepressants that have been shown to help relieve the pain, fatigue, and sleep problems in people with fibromyalgia.
The most well-studied antidepressants for fibromyalgia include duloxetine (Cymbalta), milnacipran ( Savella), and venlafaxine (Effexor). Cymbalta and Savella are specifically FDA-approved to treat fibromyalgia. There is less medical research to show that Effexor helps fibromyalgia. Other antidepressants that have also been studied for fibromyalgia and may help include citalopram (Celexa), fluoxetine (Prozac), and paroetine (Paxil).
Different antidepressants work differently in the body. In addition, what works for one person with fibromyalgia may not work for someone else. That's why people with fibromyalgia may have to try more than antidepressant to find the one that best relieves the pain, fatigue, and sleep difficulties associated with the condition. Your doctor may even want you to try a combination of more than one antidepressant at a time.