Medications

Medicines are part of the long-term treatment of fibromyalgia. They may help break the cycle of pain and sleep problems when symptoms flare up. Not all people with fibromyalgia will need, want, or benefit from medicines. People with more severe pain, sleep problems, or depression that disturbs their daily life may find medicines helpful.

Fibromyalgia symptoms in different people respond to different medicines. Your doctor may try more than one medicine before finding one that works best for you. You may also find that a medicine that has been helping your symptoms seems to become less effective over time. Talk with your doctor if you are not getting relief. He or she may try a different medicine or make suggestions for helping find new ways to modify your activity, sleep, and stress.

Medication choices

Certain types of medicines may be used to improve sleep, relieve pain and fatigue, and, in some cases, treat depression. These improvements in symptoms may allow you to feel better and to be more active. Medicines used for fibromyalgia include:

• Tricyclic antidepressants, such as amitriptyline.
• Cyclobenzaprine (Flexeril).
• Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac).
• Serotonin and norepinephrine reuptake inhibitors (SNRIs)—also called mixed (or dual) reuptake inhibitors—such as milnacipran (Savella).
• Atypical antidepressants. These are drugs that don't fit well into the general categories of antidepressant medicines. Bupropion (Wellbutrin) is an example of an atypical antidepressant that is used for fibromyalgia.
• Anticonvulsants (seizure medicines), such as pregabalin (Lyrica).

Often medicines may be combined (such as fluoxetine and amitriptyline) for the most effective treatment of symptoms of pain and sleep disruptions.

Other medicines are being studied and used for treating fibromyalgia, including:

• Pain medicines such as tramadol (Ultram), sometimes combined with acetaminophen.²

Nonprescription pain relievers, such as acetaminophen (for example, Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDS, such as ibuprofen or aspirin) usually aren't very helpful in treating day-to-day symptoms of fibromyalgia. But they may be useful in reducing severe pain caused by a flare-up of symptoms. Check with your doctor if you need to keep taking these medicines, because they may harm your stomach, kidneys, or in rare cases, your liver. Your doctor may want to monitor you if you take acetaminophen or NSAIDs daily.