Back

I have been diagnosed with fibromyalgia that may be part of a posttraumatic stress disorder. I'm not usually one to take medications but my physician is encouraging me to consider this as a way to get started. Can you tell me a little bit about the different drug choices?

Fibromyalgia syndrome (FMS) is a chronic pain problem with widespread tender points and muscle pain throughout the body. Most patients with fibromyalgia also list many other symptoms that seem to be part of this condition. Those symptoms range from depression to fatigue to decreased sexual function and difficulty sleeping. Finding one medication to alleviate all of the many symptoms isn't always possible. Pharmacologic treatment (the use of medications to aid in managing the symptoms of this condition) offers what is referred to as the first-line treatment. Nonpharmacologic treatment such as exercise, counseling, strength training, and relaxation/biofeedback is usually an important adjunct (secondary or accompanying) treatment. Managing symptoms and improving function often requires a combination of medications and nondrug approaches. It can take a while to find the right blend or mix for each individual so be patient! Your physician is the best one to advise you regarding which medication to try first. There are several different types of medications available for the treatment of fibromyalgia. The best evidence we have from research is that people with fibromyalgia have some type of dysregulation of the nervous system. Normal everyday ordinary sensory stimuli (touch, pressure, temperature, vibration) become enhanced, amplified, or altered by the nervous system until they are perceived as painful. The various medications used in the treatment of fibromyalgia attempt to alter, bypass, or downgrade these sensory messages. They include tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), selective serotonin-norepinephrine reuptake inhibitors (SSNRIs), and anticonvulsants. Finding the right drugs and the right mix or combination of those medications can take some time. Medication is the first-step. But only about a third of the patients are helped and only about a third of their symptoms are improved by this means. That's why a whole-person management approach is advised.

« Back