Fibromyalgia (FMS or FM) is a condition that causes chronic musculoskeletal pain. Addition of widespread pain characterized by sensitivity points, painful areas found in certain parts of the body. There are often other symptoms such as fatigue, headaches, cognitive problems, anxiety, depression and sleep disorders.
People with fibromyalgia often have other concomitant, diseases such as chronic fatigue syndrome / encephalomyelitis miálgica (SFC / MS), migraines, RLS (SPI) and the (IBS) irritable bowel syndrome. The Fibromyalgia often occurs together with autoimmune diseases, especially rheumatoid arthritis and lupus (SLE), but is not thought to be an autoimmune disease. The exact mechanism that causes the disease is not known yet.
Lyrica and Cymbalta the FDA has approved two drugs for fibromyalgia: Pregabalin (Lyrica) in June 2007 and duloxetina (Cymbalta) in June 2008. The Pregabalin is an anticonvulsant (medicine against epilepsy), used most often for pain disorders. Duloxetine is an antidepressant NORADRENALINE (serotonin and norepinephrine reuptake inhibitor), also used for diabetic neuropathy and stress incontinence.
In spite of being entirely different classes of drugs, both Lyrica and Cymbalta can help with the pain, trouble sleeping, fatigue, cognitive impairment, depression and anxiety caused by Fibromyalgia, although not help all and even benefit, you can not be all of the listed symptoms improve.
Similar medications pharmaceutical companies behind these drugs, of course, as we believe are magic bullets, but fortunately there are many other medications that can help the fibromyalgia. The majority of other drug manufacturers have not only invested in face trials necessary to deal with the approval of the FDA - often because the patent will expire soon and after profits fall dramatically.
For example, Gabapentin (Neurontin) is a very similar to Lyrica, which used to be widely prescribed for fibromyalgia, anticonvulsant but now Lyrica has been exceeded. Drugs have almost identical action modes. There is no clear evidence that either of the two is more efficient. Some people can tolerate pregabalin, but not Gabapentin and vice versa. Neurontin comes with a price tag a bit cheaper.
The duloxetina is not the only NORADRENALINE antidepressant. Venlafaxine (Effexor) is also a NORADRENALINE, although low-dose has no effect on norepinephrine much. Milnaciprán (tradename) is a promising antidepressants NORADRENALINE which is not yet available in the United States, but is sold in most of Europe. Fibromyalgia has shown good results in preliminary tests. It is also very cheap and it is thought that you one of the best antidepressants tolerated.
The anticonvulsants and antidepressant in general, almost all of the anticonvulsants, including major names such as carbamazepine and lamotrigine and new players such as topiramate, Zonisamide levetiracetam can help the symptoms of fibromyalgia. There are large differences in the modes of action between the drugs in this class, so even if one does not work or causes intolerable side effects, another might be worthwhile an attempt. They tend to be especially useful for pain, mood and migraine prevention problems often also to sleep.
The same applies to antidepressants, also. The reason used in Fibromyalgia is not that the Fibromyalgia is a psychiatric disorder, but are also used in many other painful as migraines, chronic headaches, painful conditions neuropathic and IBS. It is thought that the Fibromyalgia can be associated with a deficit of serotonin and norepinephrine.
As fluoxetine (Prozac) SSRI antidepressants generally are not as effective for pain. Many other antidepressants, however, also affect norepinephrine. These are tricyclic imipramine have been used to treat Fibromyalgia since 1980 and amitriptyline (Elavil) antidepressants. Used in very small doses that usually much smaller for depression. They are especially effective for sleep, but often cause too many side effects.
A third promising class of drugs NMDA antagonists is NMDA receptor antagonists. The NMDA receptor is thought to be overactive in Fibromyalgia and decreasing which could alleviate the symptoms of the disease. NMDA antagonists include antitussive dextromethorphan, amantadine, used for influenza and the disease of Parkinson's, Alzheimer and memantine Riluzole drug, a new medication used for lateral sclerosis (ALS) Amyotrophic.
Other drugs that also regulate the NMDA receptor down include, for example calcium channel blockers anticonvulsants many, some opiates (methadone and dextropropoxyphene) and muscle relaxing dantrolene and Orphenadrine. Magnesium and the taurine amino acid can also have this effect.
Hormonal treatments the Fibromyalgia also has partnered with endocrinológicos (hormonal) deficiencies, particularly of hormone growth, thyroid hormone, and vitamin D, which is considered today a steroid hormone. Others, such as estrogen, testosterone, and cortisol also been suggested as guilty.
Growth hormone has proven to be poor in a subset of people with fibromyalgia and supplements help many people. Unfortunately, the treatment must be given as an injection and is very expensive. Luckily some oral medications can also increase the growth, such as buspirone drug against anxiety, blood pressure medication clonidine and relaxing muscle baclofen hormone secretion. Melatonin can also have this effect.
Some doctors believe that thyroid supplements can even completely relieve the symptoms of fibromyalgia in some cases laboratory results are supposedly normal. On the other hand many patients have reported excellent results, even complete relief of pain with large doses of vitamin D. promising candidate drugs many drugs are currently in clinical trials for fibromyalgia. Oxibato sodium (Xyrem) is a that can also help to depression and pain sleep aid. Currently approved to narcolepsy, but is used outside the indications for severe insomnia. Several trials have demonstrated a good efficiency in Fibromyalgia, but insurance companies tend to pucker the frown to the price.
Flupirtine (Katadolon) is used in many European countries to such low back pain. It has some blocking NMDA properties and has shown a good efficiency in preliminary studies. If clinical trials are successful, the company intends that the market for fibromyalgia named mark Effirma.
Lacosamide (Vimpat) is an anticonvulsant with a new mode of action. Not yet on the market, but can be adopted in the United States and Europe by the end of 2008. A recent Phase IIa trial concluded that it was effective and well tolerated in Fibromyalgia.
Naltrexone (LDN) low-dose is a treatment that increases the secretion of endorphins, our natural analgesics. The Fibromyalgia can be associated with a deficiency of endorphins, which could also contribute to fatigue, depression and other symptoms. A trial to NLD to Fibromyalgia is currently running in the United States.
