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From Our Readers: Comments & Suggestions – 9/02/2015

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Thanks, Melissa!

Re: Even My Tired Is Tired!

I cannot add much to this except to say that it is so similar to my experience. Can someone come up with a better word than tired? Even exhaustion does not seem to describe the problem when TRYING to explain this problem to a doctor. – Matariki


Appreciate Your Article

Re: Underlying Keys to Recovery and Overcoming Obstacles

Thank you for your excellent article. It looks like you have covered the things that really help toward recovery. I really like the last point about not being well enough to take the first step. I think we forget when we are crashed all the time that it is very difficult to make any progress until you stabilize for quite a long time before baby steps can be attempted. – simyck


Evidence Please

Re: Neurogenic Neuroinflammation in Fibromyalgia and Complex Regional Pain Syndrome

…”Although fibromyalgia is most commonly associated with psychological trauma and CRPS is most often associated with physical trauma,…”

Where do they get these associations from???
Where are the reliable studies???

Almost all cases of FM that I have looked at here are associated with physical trauma, mainly with the spine. Since most associations made with psychological trauma are historical recollections the problem of associating FM with historical trauma is fraught with difficulty. Whereas the association with physical trauma is often seen with MRI.

However I do agree with the point that the patient may often regard the physical trauma that is associated with FM or CRPS as minor at the time it occurred. I suggest that “minor” spinal trauma does initiate neurogenic inflammation via the descending inhibitory pathway at the basal ganglia in susceptible people. – IanH


Too Small a Sample and Too Weak Results

Re: Lyrica Improves Fibromyalgia-Related Sleep Problems

There is nothing that says who funded this study but one can guess. This is an extremely small sample with very small results. Lyrics is known not only for its side effects but for its efficacy on only about 15% of the fibro population. I also note that the trial didn’t include the similar but “cleaner” gabapentin against Lyrica. My guess would be that the results would be similar if not better for those who responded to a drug.

Absent from the abstract was also the screening process. Both Lyrica and gabapentin have some efficacy in preventing waking/sleep disruption in the middle of the sleep cycle but are not as effective for inducing sleep or early waking problems. – MarcieRose


Long Term Use of Melatonin

Re: Melatonin Helps Fibromyalgia Pain: A Double-Blind Study

Can Melatonin at night become addictive? If stopped will insomnia occur? – JanetRae
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Melatonin is not addictive and “withdrawal” symptoms are typically minor or absent. It depends on the dose used more than the number of days taking it. Typical doses are 0.5 to 1mg. In this study as in some other studies using melatonin for analgesia the dose has been 5mg to 10mg. (There is a substantial section of the Journal of Pineal Research set aside for analgesic melatonin) With this higher dose it would be wise to reduce the dose gradually. Another alternative is to switch to Melatonin SR. This releases melatonin slowly over the night.

One side effect of higher doses like 10 mg can be irritability in some people. This typically does not occur at 5mg or less.

Another bit of advice for those wanting to use the doses in this study. We have found that amitriptyline (Elavil)25mg with melatonin 10mg taken at night is even more effective if supplemented with 100mg 5-HT in the daytime (breakfast). This is even quite effective for focal pain such as back pain. – IanH


Confirmation at Last

Re: Potential Sleep-Related Treatment Targets for Fibromyalgia Identified

I’ve long thought that my daughter’s fibro is caused by,or at least strongly connected to, her sleep disorder. When I can let her sleep in during summer break, her pain almost vanishes. When I have to hound her out of bed, against her delayed body clock, the fibro roars back. Now for a treatment…! – Schnitzel

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