Two pharmaceutical drugs have been approved by the FDA for the treatment of fibromyalgia: Lyrica and Cymbalta. Lyrica is an anticonvulsant that binds to a specific protein within overexcited nerve cells and works to calm damaged nerves. This is thought to reduce the level of pain in FM patients. Cymbalta is a serotonin-norepinephrine reuptake inhibitor (SNRI) antidepressant. It is thought to work by increasing the activity of serotonin and norepinephrine in the central nervous system. These are two neurochemicals known to be low in FM patients.
Other medications may be prescribed off-label to treat FM symptoms. Some of these include:
- Anticonvulsants - for pain, sleep and mood stabilization
- Antidepressants - (SSRI, SNRI or tricyclic) - for depression, sleep and pain
- Sleep - initiators and sustainers
- Analgesics - (NSAID, Cox II inhibitor, opioid, topical) - for pain
- Stimulants - for energy improvement and mental acuity
- Muscle Relaxants - for pain and sleep
People with fibromyalgia are often highly sensitive to medications, therefore, dosages should usually be started at low levels and gradually adjusted to a level that is both well-tolerated and therapeutic.
Every patient is different. What works for one may not work for another. Physicians and patients need to work together to discover which drug, or combination of drugs, works best.