A guide to fibromyalgia medication

Fibromyalgia is a chronic, long-term health condition that causes a variety of symptoms. If you have fibromyalgia, you may notice symptoms ranging from fatigue and body aches to problems with concentration.

This condition can be hard to manage on your own, but there are a variety of treatments available to help keep your symptoms manageable, allowing you to live and enjoy a good quality of life. Doctors often recommend a combination of different treatments, which include medication and lifestyle or natural remedies like physical activity and acupuncture.

Everyone experiences fibromyalgia differently, meaning the treatment plan that works best for you may not be best for someone else.

What is fibromyalgia?

According to the Centers for Disease Control and Prevention (CDC), around 4% of people in the United States experience fibromyalgia. While researchers are still unsure about what causes the condition, they believe that certain triggers, such as stress and severe trauma, may cause symptoms to develop.

Doctors refer to the main symptoms of fibromyalgia as regions of pain. These are areas of pain that often overlap. You may hear them called trigger points or tender points. Fibromyalgia pain is typically a dull but consistent ache.

Other symptoms of fibromyalgia that you may notice include:

• fatigue
• dry eyes
• trouble sleeping
• headaches
• depression and anxiety
• rash
• bladder and digestive problems like irritable bowel syndrome  
• difficulty concentrating
• brain fog
• coldness or excessive sweating
• heart palpitations

Fibromyalgia can be difficult to understand because its symptoms are similar to a wide range of other conditions. Treatment focuses on managing your different symptoms rather than curing the condition.

Antidepressants

The Food and Drug Administration (FDA) has approved certain antidepressant medications for helping manage fibromyalgia symptoms like difficulty sleeping, pain, and depression.

If a doctor recommends antidepressants to help manage your symptoms, it does not necessarily mean you are depressed. These drugs provide relief by rebalancing the chemicals in your brain. The rebalancing process can help address other issues in addition to addressing mood concerns.

FDA-approved antidepressants for managing fibromyalgia include duloxetine (Cymbalta) and milnacipran (Savella).

What’s more, amitryptiline (Elavil) is often used off-label to treat symptoms of fibromyalgia. Prescription drug off-label use means the drug is not FDA-approved for treating fibromyalgia, but doctors prescribe it because they’ve found it helpful in addressing some symptoms.

For example, some research finds that amitryptiline may be more effective than duloxetine at managing fatigue and sleep quality in people living with fibromyalgia.

It’s important to note that you should not consume alcohol when taking this antidepressant. Speak with a healthcare professional if you have any questions or concerns.

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Muscle relaxants

Muscle relaxants, or antispasmodics, are a type of medication that doctors often prescribe off-label to help manage symptoms of fibromyalgia.

They help soothe body pains by relaxing your muscles to relieve uncontrollable muscle spasms.

These medications include tizanidine (Zanaflex) and cyclobenzaprine (Flexeril).

Anticonvulsants

Pregabalin (Lyrica) is an FDA-approved anti-seizure medication that’s designed to help manage pain associated with fibromyalgia. It works by balancing the chemicals in the brain to reduce the sensitivity of your nerve cells to pain signals. It is one of the first medications that doctors could prescribe for managing fibromyalgia symptoms.

Side effects of pregabalin do occur, but they are not often severe enough to interfere with your daily life. For example, 10 percent of people taking pregabalin experience clinically significant weight gain and is considered mild.

According to research from 2016, taking pregabalin helps improve sleep and cognitive symptoms. It generally helps boost the quality of life in people with fibromyalgia. It can also provide pain relief.

Pain relievers

Certain pain-relieving medications can be effective and safe for managing pain from fibromyalgia. If your pain is mild, over-the-counter (OTC) pain relievers may be enough to reduce discomfort. These include nonsteroidal anti-inflammatory drugs (NSAIDs) and analgesics, including:

• acetaminophen (Tylenol)
• naproxen (Aleve)
• ibuprofen (Advil)
• aspirin

According to a review of 10 clinical trials from 2022, the pain-relieving drugs acetaminophen and tramadol (Ultram) are an effective combination treatment for resistant fibromyalgia pain. Researchers also noted that the combination treatment does not produce any serious side effects.

Natural remedies

Fibromyalgia is a complicated condition that researchers are still working to try and understand. Lifestyle changes and natural remedies may help alleviate your symptoms in addition to medication.

Some of these natural remedies include:

• Reducing your stress: Sometimes stress seems to trigger fibromyalgia symptoms, and researchers have found links between the risk of developing the condition and experiencing stress or traumatic events. If you’re experiencing stress, you might consider taking yoga classes or making time to do things that bring you joy to help reduce and manage it.

• Massage: Gentle manipulation of your muscles helps sore muscles and joints. Massage may be helpful for fibromyalgia pain.

• Regular physical activity: Staying physically active, like regularly exercising, when living with fibromyalgia can be difficult. Starting a physical activity that is right for you and regularly engaging in that activity may make it easier to build up your tolerance. Building muscle strength over time can help reduce pain. If you are unsure where to start, consider speaking with a doctor to help you create a plan for engaging in physical activities that are safe for you.

Summary

Fibromyalgia is a condition that researchers and healthcare professionals like doctors have limited information about in some areas, but knowledge is improving through ongoing research.

If you are experiencing pain without a known cause, you may want to speak with a doctor about the possibility that you may have fibromyalgia. In addition to providing information about the condition, a doctor can also recommend treatments.

Treatments for fibromyalgia can include medications such as several FDA-approved drugs. There are other drugs that healthcare professionals may prescribe off-label for fibromyalgia symptoms. Lifestyle changes and natural remedies may also help provide symptom relief.

A doctor will be able to help you decide which treatment plan works best for you, and your best treatment plan will be highly individualized and based on addressing your specific health needs.

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