Medications
Anti seizure
Lyrica (pregabalin) is the first and only treatment approved by the FDA for the management of Fibromyalgia.
Neurontin (gabapentin) can be helpful to treat pain.
Analgesics
Analgesic medications like Tylenol (acetaminophen) or NSAIDS (like motrin, aleve, advil, ibuprofen) or ultram or Ultracet (ultram/acetaminophen) may used to treat the pain of fibromyalgia.
Antidepressants
1. Tricyclic Antidepressants like amitriptyline (Elavil), nortriptyline (Pamelor) or doxepin (Sinequan) can be helpful to treat sleep and depression.
2. Selective serotonin reuptake inhibitors (SSRIs) antidepressants like fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and citalopram (Celexa) are very effective in treating depression.
3. Other antidepressants like duloxetine (Cymbalta) or venlafaxine (Effexor) may also be helpful in fibromyalgia.
Muscle relaxants
Muscle relaxants cyclobenzaprine (Flexeril) or methocarbamol (Robaxin) are used to treat the muscle pain and spasm associated with fibromyalgia. They tend to work better during acute flares, rather than with chronic use. Tizanadine (Zanaflex) may help both muscle spasm and pain.
Dopamine agonist
Pramipexole (Mirapex) has been shown to help some patients with fibromyalgia.
Other medications
Medications like benzodiazepines, narcotics, and steroids (like prednisone) have a limited role in treating fibromyalgia and have not shown long term benefits. Benzodiazepines and alcohol can affect quality of deep sleep. Some people believe that guaifenesin helps with their pain.
Trigger point injections
These are injections into painful areas in your muscles. This can be safely performed in your doctor’s office. They may use medications such as lidocaine or steroids. These injections usually provide temporary relief.
Nonpharmacologic treatment and Self-management
Education and counseling: This is very important for persons with fibromyalgia to have the information they need to help manage their disease over a lifetime. This helps improve outcome, outlook, and coping with chronic issues.
Biofeedback and Cognitive behavioral therapy: These interventions have been shown to decrease pain, depression, sense of disability, and improve self-esteem.
Exercise: Studies have shown that regular aerobic exercise can improve strength, mobility, physical function, aerobic capacity, and depression in persons with fibromyalgia. It can also help prevent bone loss associated with inactivity.
Nutrition and Diet: A well-balanced diet is recommended for all persons with fibromyalgia. There is no proven nutritional supplement for persons with fibromyalgia. Some patient report decreased symptoms and feeling better when they follow a low carbohydrate diet.
