Fibromyalgia is a condition in which the symptoms experienced mimic other conditions. Common symptoms include generalized muscle and joint pain and fatigue. The cause, or causes, of fibromyalgia is still being investigated. To date, there are no definitive laboratory tests with which to make a diagnosis. However, this diagnosis is typically made based on clinical observation and after other diseases have been ruled out. There is no known cure and treatment focuses on controlling the symptoms.
Lyrica
The first drug approved by the US Food and Drug Administration (FDA) specifically for use in fibromyalgia was Lyrica. This FDA approval was announced in 2007. Lyrica was initially approved for use as an anti-seizure medication and to relieve neuropathic pain. It has not been clearly established as to how this drug works in the treatment of fibromyalgia, but it is thought to assuage overactive pain signals. Lyrica is a capsule that may be taken two times a day. The maximum daily dose is 450 mg. Common side effects include dizziness, drowsiness, weight gain and swelling in the hands and feet. Any new onset of depression or suicidal thoughts after beginning Lyrica should be immediately reported to the physician. Men and women who are planning to become parents after initiating this treatment should discuss these plans with a physician. Lyrica should not be stopped suddenly; the dosage must be reduced over time as directed by the doctor.
Cymbalta
In 2008, the FDA approved the antidepressant, Cymbalta, as a treatment for fibromyalgia. This drug helps to alleviate the pain and fatigue that can be debilitating for those with fibromyalgia. Improvement of fibromyalgia symptoms have been experienced within one week of initiating treatment. Cymbalta is typically taken once a day with a maximum daily dose of 60 mg. Common side effects are dry mouth, nausea, increased sweating and drowsiness. Mood changes, signs of liver dysfunction and any new muscle pain should be reported to the prescribing physician immediately. Those who are on MAOIs and Mellaril are advised to not take Cymbalta for treatment of fibromyalgia.
Savella
Savella, another antidepressant, was approved by the FDA for use in the treatment of fibromyalgia in early 2009. Found to be effective at a daily dose of 100 mg, Savella helps to relieve the pain associated with fibromyalgia. Like Cymbalta, symptom improvement within one week of initiating treatment has been reported. How Savella works is somewhat unclear, but it is thought to have an effect on chemicals in the brain which may control pain perception. The usual side effects of this fibromyalgia treatment are similar to those of Cymbalta. Additionally, some people may experience increased heart rate, constipation and an increase in blood pressure.
TENS
Transcutaneous electrical nerve stimulation (TENS) is an alternative therapy which involves the transmission of electrical impulses to nerve paths. It is a treatment most commonly used to help with painful conditions such as carpel tunnel and musculoskeletal injuries. TENS therapy may help to provide some temporary pain relief in fibromyalgia and is typically not a stand-alone treatment. It is most likely suggested in situations where the current treatment is not effectively alleviating the pain. It is also an alternative offered to those patients who wish to try something other than medication.
Considerations
Establishing an effective individual treatment for fibromyalgia may not be easy as the severity and combination of symptoms varies from person to person. A new medication may not work as quickly for some as it does for others, if it works at all. Communication with the treating physician is important. Not only should adverse effects be reported, but the doctor should also know to what extent the treatment is effective. Fibromyalgia research is ongoing and new treatments are currently in the clinical trial phase. There are also many alternative and complementary which are being investigated. It is advised that no alternative treatment be initiated without consulting a physician.
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