Fibromyalgia is a disease causing musculoskeletal pain. It is featured by painful areas in some body parts. Other symptoms include headaches, fatigue, sleep disturbances, cognitive problems, depression and anxiety.
Patients who have fibromyalgia often have other comorbid diseases, including migraines, myalgic encephalomyelitis, restless legs syndrome, irritable bowel syndrome. Fibromyalgia is generally accompanied by autoimmune diseases, particularly lupus or by rheumatoid arthritis. What causes the disease is not yet discovered.
Cymbalta, Lyrica
We should mention that there are two drugs for fibromyalgia approved by the FDA, including duloxetine (Cymbalta) and pregabalin (Lyrica). Pregabalin belongs to anticonvulsants, although it is more frequently taken for different pain disorders. Duloxetine is in a group of SNRI antidepressant also taken in treating stress incontinence and diabetic neuropathy.
Although Lyrica and Cymbalta belong to different drug groups they help to alleviate pain, fatigue, sleeping problems, depression, cognitive impairment and also anxiety provoked by fibromyalgia.
Anticonvulsants And Antidepressant drugs
Nearly all anticonvulsants, also older names such as lamotrigine, carbamazepine and newer drugs like levetiracetam, zonisamide, topiramate can be useful in treating fibromyalgia symptoms. The modes of action of the drugs in this group differ greatly, so if one doesn’t work, you may try another one. These drugs are especially effective for mood problems, pain as well as migraine prevention.
The same is relevant for antidepressants. They are taken for treating fibromyalgia as well as in migraines, neuropathic pain, chronic headaches and IBS. Fibromyalgia might be caused by norepinephrine and serotonine deficit.
Such SSRI antidepressants as Prozac (fluoxetine) are usually not very effective for alleviating pain. Other antidepressant drugs can also affect norepinephrine. They are such tricyclic antidepressants as Elavil (amitriptyline) also imipramine that have already been used in the treatment of fibromyalgia since 1980s. These medications should be used in really small dosages, much smaller than used in the treatment of depression. These antidepressants are particularly effective and useful for sleep, however they can often provoke a lot of adverse effects.