There is a wide variety of drugs used to treat fibromyalgia. Some reduce pain, some relax tense muscles, some help with sleep, and some seek to correct neurochemical imbalances. Many fibromyalgia patients take a combination of drugs to relieve symptoms; it can take some time and experimentation to find the optimal set of medications for an individual patient.
The most commonly used pain-relieving drugs are analgesics and non-steroidal anti-inflammatory drugs (NSAIDs). Most of these are available in both over-the-counter and prescription strengths.
- Acetaminophen (Tylenol)
- Ibuprofen (Advil, Motrin)
- Naproxen (Aleve, Naprosyn)
Another drug used to relieve fibromyalgia pain is tramadol (Ultram or Ultracet when combined with acetaminophen), a stronger painkiller available only by prescription.
In rare cases, a doctor may prescribe opioid painkillers for severe pain. However, these drugs carry a high risk of addiction if used regularly for a long period.
- Hydrocodone and acetaminophen (Vicodin)
- Oxycodone (Oxycontin)
- Oxycodone and acetaminophen (Percocet)
Like fibromyalgia, depression is associated with imbalances in brain chemicals. Thus, many drugs that affect levels of these chemicals are used for both depression and fibromyalgia. There are a number of antidepressant drug categories that can help fibromyalgia symptoms:
Tricyclic antidepressants keep levels of serotonin, norepinephrine, and dopamine elevated.
- amitryptaline (Elavil)
- nortryptaline (Pamelor)
- doxepin (Sinequan)
- trazadone (Desyrel)
- imipramine (Tofranil)
Side effects of tricyclic antidepressants include drowsiness, dizziness, sexual dysfunction, and weight gain.
Selective Serotonin Reuptake Inhibitors (SSRIs)
Selective serotonin reuptake inhibitors (SSRIs) increase serotonin levels and also keep serotonin circulating in the brain for longer periods.
- citalopram (Celexa)
- escitalopram (Lexapro)
- fluoxetine (Prozac)
- paroxetine (Paxil)
- sertraline (Zoloft)
Side effects of SSRIs include nausea, headache, diarrhea, restlessness, and sexual dysfunction.
Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)
Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs) work in a similar manner to SSRIs but affect both serotonin and norepinephrine.
- duloxetine (Cymbalta)
- milnacipran (Savella)
- venlafaxine (Effexor)
Side effects of SNRIs include nausea, vomiting, dizziness, and insomnia.
Anticonvulsants are drugs used to prevent seizures. They calm overactive nerves and affect the pain transmission pathway, both of which can improve fibromyalgia symptoms.
- carbamazepine (Tegretol)
- divalproex (Depakote)
- gabapentin (Neurontin)
- oxcarbazepine (Trileptal)
- phenytoin (Dilantin)
- pregabalin (Lyrica)
- tiagabine (Gabitril)
- topiramate (Topamax)
- valproic acid (Depakene)
Side effects vary from among anticonvulsants but can include nausea, vomiting, drowsiness, and liver damage.
Muscle relaxants reduce pain and muscle soreness, and they also help relax the body and improve sleep.
- carisoprodol (Soma)
- cyclobenzaprine (Flexeril)
- orphenadrine (Norflex)
- metaxolone (Skelaxin)
- methocarbamol (Robaxin)
Side effects of muscle relaxants include blurred vision, dizziness, and drowsiness.
Benzodiazepines relieve anxiety, relax muscles, and improve sleep. They cause drowsiness, so they are usually taken at bedtime.
- clonazepam (Klonopin)
- diazepam (Valium)
- temazpam (Restoril)
- alprazolam (Xanax)
Side effects of benzodiazepines include drowsiness, confusion, impaired coordination, and depression. It is important to limit benzodiazepine use because it can be addictive.
Sleep aids not only help a person fall asleep, they can also help maintain sleep for longer periods and make sleep deeper.
- eszopiclone (Lunesta)
- ramelteon (Rozerem)
- temazepam (Restoril)
- triazolam (Halcion)
- zaleplon (Sonata)
- zolpidem (Ambien)
Sleep aids can be habit forming, meaning that if you take them for a long period and then stop, you may experience anxiety and trouble sleeping. Other side effects include dizziness, headache, drowsiness, and sleepwalking.