Medications for Treating Fibromyalgia

The most helpful treatment approach for fibromyalgia is a combination of self-care, physical activity and cognitive-behavioral therapy. But medication may also be needed. Many drugs prescribed for fibromyalgia work to turn down “pain volume” in the central nervous system (CNS).

They can also help reduce fatigue, improve mood, promote sleep and ease other problems associated with fibromyalgia, including irritable bowel and restless legs syndromes. Drugs such as NSAIDs, opioids and corticosteroids have not been found to be effective for fibromyalgia pain.

Common Medications for Fibromyalgia

Duloxetine (Cymbalta), milnacipran (Savella) and pregabalin (Lyrica) are FDA-approved to specifically treat fibromyalgia. Others are used “off-label” – meaning, they’re used by doctors because of observed benefits but are not FDA-approved for fibromyalgia. Some of those drugs are antidepressants but that doesn’t mean that getting a prescription for your fibromyalgia means you are depressed.

The risks, side effects, and warnings listed below are not complete and you may experience more than these effects.  Tell your doctor about all medicines you are taking, including over-the-counter drugs. Always read the full prescribing information when starting a new medication.

Medications for Treating Fibromyalgia

Fibromyalgia is a chronic condition characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, and cognitive difficulties. Treatment often involves a combination of medications, lifestyle changes, and therapies. Here’s an overview of medications commonly used for fibromyalgia management:

FDA-Approved Medications

1. Duloxetine (Cymbalta):
   • Class: Serotonin-norepinephrine reuptake inhibitor (SNRI).
   • Use: Reduces pain and improves mood.
2. Milnacipran (Savella):
   • Class: SNRI.
   • Use: Addresses pain and fatigue symptoms.
3. Pregabalin (Lyrica):
   • Class: Anticonvulsant.
   • Use: Reduces pain by calming overactive nerve signals.

Off-Label Medications

1. Gabapentin (Neurontin):
   • Class: Anticonvulsant.
   • Use: Similar to pregabalin for nerve pain relief.
2. Amitriptyline:
   • Class: Tricyclic antidepressant.
   • Use: Improves sleep and reduces pain.
3. Cyclobenzaprine (Flexeril):
   • Class: Muscle relaxant.
   • Use: Eases muscle tension and promotes better sleep.
4. Selective Serotonin Reuptake Inhibitors (SSRIs):
   • Examples: Fluoxetine (Prozac), sertraline (Zoloft).
   • Use: Improves mood and reduces fatigue.

Pain Relievers

1. Acetaminophen:
   • Mild pain relief.
2. Nonsteroidal Anti-inflammatory Drugs (NSAIDs):
   • Examples: Ibuprofen, naproxen.
   • Use: May help with inflammation, though fibromyalgia is not primarily inflammatory.
3. Tramadol (Ultram):
   • Use: Prescribed for moderate to severe pain.

Additional Considerations

• Sleep Aids: Medications like zolpidem (Ambien) or over-the-counter melatonin may improve sleep.
• Muscle Relaxants: For severe muscle stiffness.
• Vitamin D Supplements: If levels are low, supplementation might help reduce pain and fatigue.

Non-Medication Strategies

Medications are often more effective when combined with non-pharmacological approaches, such as:

• Regular physical activity (e.g., low-impact exercises).
• Cognitive Behavioral Therapy (CBT).
• Stress management techniques like yoga or meditation.

Consult a healthcare provider to develop a tailored treatment plan, as individual responses to medications can vary.