NYU Langone doctors may prescribe one or more medications to help alleviate the chronic pain of fibromyalgia. No two people with fibromyalgia have exactly the same symptoms, so your doctor carefully considers your symptoms and other medical conditions when recommending a medication.
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Antidepressants
Antidepressants are commonly prescribed for people with fibromyalgia. These medications may reduce fibromyalgia pain and fatigue by increasing the amount of certain neurotransmitters, or chemicals, in the brain. These neurotransmitters can help to decrease your sensitivity to pain.
One class of antidepressants, called serotonin–norepinephrine reuptake inhibitors, raises the levels of two neurotransmitters—serotonin and norepinephrine—in the brain. These neurotransmitters are responsible for regulating mood and sensitivity to pain. These medications, such as duloxetine (Cymbalta®), are taken daily by mouth to reduce the pain and fatigue caused by fibromyalgia.
Tricyclic antidepressants have a sedating effect in addition to boosting the levels of neurotransmitters in the brain. These medications may be used to improve sleep.
Possible side effects of these medications include drowsiness, dizziness, headache, dry mouth, weight gain, dry eyes, sexual dysfunction, difficulty urinating, and gastrointestinal discomfort.
Anticonvulsants
Anticonvulsants, such as pregabalin (Lyrica®), can also help to reduce the pain associated with fibromyalgia. These medications are taken daily by mouth and work by calming overactive nerve cells that send pain signals throughout the body. Anticonvulsants can also help to improve sleep.
Side effects of anticonvulsants may include drowsiness, dizziness, fluid retention, and weight gain.
Nonsteroidal Anti-inflammatory Drugs
Doctors sometimes recommend nonsteroidal anti-inflammatory drugs (NSAIDs) to ease deep muscle and joint pain caused by fibromyalgia. NSAIDs, such as ibuprofen and naproxen, are available without a prescription.
These medications may be more effective in relieving pain when combined with other medications used to manage fibromyalgia.
Taking large doses of NSAIDs for long periods of time can increase the risk of heartburn or gastrointestinal bleeding and lead to cardiovascular, kidney, and liver problems. NSAIDs can also cause fluid retention.
Your doctor can advise you on the best way to use these medications as part of your treatment plan.
Muscle Relaxants
Doctors sometimes prescribe muscle relaxant medications to reduce pain. They can also improve sleep in people with fibromyalgia.
Common side effects of muscle relaxants include dizziness, drowsiness, blurred vision, difficulty urinating, constipation, and dry mouth.