GP Resources

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Fibromyalgia and Medications:

Presently, no single medication alleviates all of a Fibromyalgia patient's pain and accompanying symptoms. This makes it doubly important for physicians to keep updated regarding results of ongoing FMS research and current changes in recommended fibromyalgia treatments. Before prescribing a medicine for a patient it is the responsibility of the attending physician to elicit a comprehensive medical history. Because different symptoms accompany each FMS patent, the doctor needs to know what problems are specific to each individual. For instance, non-restful sleep is almost always a major concern for Fibromyalgia sufferers. Small doses, usually 10 mg, of an antidepressant seem to help many FMS people. It is important for the physician to encourage the patient to keep a detailed written journal of medicines, dosages, timing and side effects. This record will be beneficial to the patient as well as the doctor when writing a prescription. It takes time and communication between the health care professional -and patient to determine the correct FMS medication, proper dosages and appropriate time to take the prescriptions. Please ensure you take no drugs prescription or otherwise, without your doctor's knowledge and agreement - this applies equally to supplements, which can be harmful in certain instances.  All dosages are suggestions for physicians unfamiliar with using them, but caution should be applied to ensure that an individual obtains the right dose is given for their particular circumstances e.g. antidepressant dosages will be tailored according to the purpose given i.e. for sleep disturbance or actual depression.   As always we emphasise that this information is purely a guide - your GP may prescribe more or less of any particular drug in any given circumstance - if you wish to have more in-depth information on any particular drug please go to the Links page where you can visit the drug databases online and obtain fully up-to-date information.

 **Prescription medications at doctor's discretion. **

SEROTONIN- BOOSTING MEDICATIONS (SSRI's)

Fluoxetine - Prozac 1-20 mg AM
Paroxetine - Seroxat 5-20 mg AM
Sertaline - Lustral 50-100 mg AM
Nefazodone - Dutonin 100 -200 mg AM/PM
Venlafaxine - Efexor 7.5-150 mg AM
Citalopram- Cipramil 10-20 mg
Escitalopram-Cipralex 5-10 mg

These are deemed particularly useful in helping with sleep disturbance, but also alleviate mood disorders sometimes associated with FMS.

Prozac (Fluoxetine) is available in liquid as well as tablet form. A typical dose is 1 to 20 mg in the morning. Prozac may cause insomnia, but it can be taken in combination with one of the sedating tricyclics such as Tryptizol or Sinequan.

Seroxat (Paroxetine hydrochloride) the usual dose is 5 to 20 mg in the morning. This medication is the most potent of this type. A sedating medication may be needed at night in conjunction with Seroxat. It can cause nervousness, insomnia, nausea, sexual difficulties and sweating, although many patients report having fewer side effects with this as compared to Prozac

Lustral (Sertaline ) is similar in action to Prozac being less sedative than the Tricyclic drugs and shouldn't cause weight gain. Dose is initially 50 mg daily increased to a maximum of 100 mg unless side-effects such as gastrointestinal upsets are severe.

Prothiaden (Dothiepin hydorchloride). Similar to the others, this drug is often given if anxiety plays a large role in your Fibromyalgia. It has sedation as well as anti-depression properties. Dosages start around 50 - 75 mg, if given purely for the sleep deficit.

Effexor (Venlafaxine Hydrochloride) usual dose is 37.5 mg two times per day. This dosage can be adjusted, depending on the effects. Effexor is not related to the tricyclics or the Prozac like drugs, however, it does boost serotonin and has tricyclic properties. The typical side effects are nervousness, anxiety, insomnia, and increased blood pressure.

Cipramil ( Citalopram) Similar in effect to Lustral but smaller dosing.

Cipralex ( Escitalopram) Also similar to Lustral but with fewer side effects, which can make it useful for anyone finding the latter difficult to cope with.