Insomnia, fatigue and pain are my main symptoms of fibromyalgia. As you probably know, the insomnia makes the other two worse. Although the fatigue of fibro is so much more than simply being tired, without adequate sleep, of course we’re fatigued. And minus the good Stage 4 sleep, our bodies lack the deep, restorative effects of slumber which only increases our pain. It’s a depressing circle.
The first line of defense prescribed after my diagnosis of fibromyalgia was an antidepressant, and I’ve been on several different ones in the past three decades. Almost all of them, however, including the one I currently take, have been SSRIs – selective serotonin reuptake inhibitors. SSRIs affect our neurotransmitters, chemicals that nerves within our brains use to communicate with each other.
Neurotransmitters are manufactured and released by nerves and then travel and attach to nearby nerves. Thus, neurotransmitters can be thought of as the communication system of the brain. Many experts believe that an imbalance among neurotransmitters is the cause of depression. Citalopram works by preventing the uptake of one neurotransmitter, serotonin, by nerve cells after it has been released. Since uptake is an important mechanism for removing released neurotransmitters and terminating their actions on adjacent nerves, the reduced uptake caused by citalopram results in more free serotonin in the brain to stimulate nerve cells.
Serotonin has many functions in our body, including contributing to wellbeing and happiness, hence, its moniker “the happy chemical.” A major function for those of us with fibromyalgia, though, is that it also helps regulate our sleep-wake cycles and our internal clock, helping us to wake up feeling refreshed.
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Unfortunately for many of us, including me, the daily SSRI dose and all the other medications and supplements I take, including a nightly dose of Ambien taken with a drink of tart cherry juice, we still do not sleep well. Per my Fitbit, my average REM cycle is 12% of the night, and my time in deep sleep is only 10%. Regardless of how many hours I stay in bed, I am always tired, sleepy and fatigued. That ugly circle again.
So when a friend who is very informed about health issues and also suffers from chronic insomnia told me that she takes a nightly dose of 5-HTP and GABA every night and uses Ambien only occasionally, I decided to try it. Without first researching what either substance is. Not a wise idea.
Both 5-HTP and GABA are neurotransmitters that block impulses between nerve cells in the brain – including serotonin! The combination of an antidepressant plus these two additional neurotransmitters can lead to TOO MUCH serotonin in your body, leading to serotonin syndrome. For example, this short video describes why you shouldn’t take 5-HTP and antidepressants.
Admittedly, one dose of these supplements plus my other prescription medications is not going to produce serotonin syndrome. But it was so difficult to get out of bed this morning – much worse than usual – that I decided to do a little research on these two new supplements. There’s much more for me to learn about serotonin, 5-HTP, GABA and fibromyalgia, but my lesson for today is to NOT take any new supplement or medication without first doing my research to determine interactions with what I already take.
Cindy Leyland is ProHealth’s Fibromyalgia Editor. Cindy also serves as the Director of Program Operations at the Center for Practical Bioethics and the PAINS-KC Project Director. She lives in Kansas City with her husband, enjoys hiking, reading, and being Gramma Cindy.