Typically, a person who has just been diagnosed with fibromyalgia has been experiencing fatigue and pain for several months. Often, several healthcare professionals have been consulted before the diagnosis of FM is made, which has led to delays in treatment.
At this stage of the condition, the person usually feels pain throughout the body, doesn’t sleep well, feels tired, and has difficulty concentrating. Medication is then an option to consider, both to relieve the individual and to help them regain control of their life.
Several classes of medications help relieve pain, improve sleep or mood, and, of course, improve a person’s quality of life. The attending physician selects medications based on the symptoms reported by the individual.
Hypersensitivity Calmed by Medication
People with FM have heightened sensitivity to touch, smells, noises, changes in temperature, medications, etc. This condition is due in part to the hyperexcitability of their central nervous system. Fibromyalgia is sometimes likened to a car with the gas pedal “to the floor”. One of the ways to manage the pain is to calm the nervous system, to “take the foot off the gas” or “put on the brakes”, so to speak.
Specific medications are available to reduce the hyperexcitability of the central nervous system. However, it may take several trials of medication to find the one that best suits the health status of the person with FM. Each person is unique and may respond differently to the same medication.
Antidepressants
Low doses of antidepressants are part of the drug therapies used to treat fibromyalgia. These drugs affect neurotransmitters, such as serotonin, noradrenaline, and dopamine, which may help people with FM.
In the brain, serotonin and noradrenaline are thought to be associated with mood and with regulating and reducing pain sensations originating in the body. As for dopamine, it is thought to affect appetite as well as the loss of pleasure, energy, and motivation.
Targeted Medications for Fibromyalgia
Duloxetine and pregabalin are medications specifically targeted by Health Canada for the treatment of fibromyalgia. These medications calm nerve activity and are effective in relieving chronic pain and sleep disturbances.
Muscle Relaxants
Muscle relaxants relieve pain by reducing muscle spasms. They relieve stiffness and may help with anxiety and insomnia.
Opioids
Opioids are powerful painkillers in a class of drugs that have effects similar to those of morphine. They are rarely used to treat fibromyalgia. However, tramadol may be prescribed in certain cases.
Opioids help relieve pain, but they should not be used for extended periods because of their highly addictive quality. They should only be used as a last resort when other treatments have proven ineffective. And when they are prescribed, their use must be closely monitored by the doctor and the pharmacist.
Some Factors to Consider When Taking Medication
The hypersensitivity of people with fibromyalgia is well documented. When treating with medication, doctors often start with low doses that they gradually increase. The initial dose is usually lower than that recommended by the manufacturer. Therefore, if the patient feels that their medication is not producing the expected results, they should discuss this with their doctor.
It’s also important to avoid stopping certain medicines abruptly, except in the case of a serious allergic reaction. For example, when the doctor stops or changes antidepressants, it may be necessary to gradually lower the dose of certain medicines to reduce the risk of side effects. This is called drug withdrawal.
Finally, over-the-counter medicines, natural products, and supplements should be used with caution. They may produce harmful side effects or interact with the medication prescribed to treat the condition. It’s always advisable to check with the pharmacist for possible interactions before taking any of these products.