By Dr Ananya Mandal, MD
Fibromyalgia is a widespread pain disorder that affects females more than males. The condition as of now has no cure and is mainly treated symptomatically.
Several medications, however, have been found to be useful in fibromyalgia. Some of these include:-
These commonly belong to a class of drugs called the Non steroidal anti inflammatory drugs or NSAIDs. The drugs of this class include paracetamol, diclofenac, ibuprofen etc. These are commonly available over the counter and may relieve pain.
NSAIDs are associated with numerous side effects including peptic ulcers, gastroesophageal reflux disease and kidney diseases.
If NSAIDs like paracetamol are ineffective, a synthetic opioid Tramadol may be added to it. Tramadol is more effective in pain relief but may also cause diarrhea, fatigue and withdrawal symptoms when discontinued.
These agents are useful in treating depression. The agents mainly act by increasing the levels of certain neurotransmitters, such as serotonin, noradrenaline and dopamine. These chemical messengers normally send information within the structures of the brain and are thought to be deficient in depression as well as fibromyalgia.
There are different types of antidepressants. Symptom severity determines the choice of medication. Some of the antidepressants in use include:-
Tricyclic antidepressants that include Amitriptylline - this raises the levels of serotonin and noradrenaline
Selective serotonin reuptake inhibitors (SSRIs) include Fluoxetine, Paroxetine etc. that raise the levels of serotonin
Serotonin-noradrenaline reuptake inhibitors such as Duloxetine raise the levels of both serotonin and noradrenaline
Other agents that raise the brain levels of neurotransmitters include Pramipexole and Tropisetron.
Tranquillizers and sedatives
Sleep problems are common with fibromyalgia. Certain medications that induce sleep maybe useful in these patients. These include Diazepam, Lorazepam, Alprazolam etc.
Muscle relaxing agents
Some medications prevent muscle spasms and stiffness and may ease pain. These include Diazepam, Tizanidine etc.
Some patients benefit from anti-epilepsy or anti-seizure medications. The most commonly used anticonvulsant in fibromyalgia is Pregabalin.
Drugs used in psychiatric ailments or antipsychotics – these agents are also called neuroleptics and may benefit patients with fibromyalgia.
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)