(updated June 2021)
It often takes years and numerous doctor visits before someone gets the diagnosis of fibromyalgia. During that time, you’re passed from one doctor to the next….
Fibromyalgia-What You Should Know About Antidepressants
Once you do get the diagnosis of fibromyalgia, many doctors will start to ignore your complaints and simply tell you you’ll have to “learn to live with it.” Some will become less attentive, and perhaps even refer you to another doctor. More and more rheumatologists are deciding not to treat fibromyalgia patients. Patients often wind up going from one doctor to another, hoping to find someone who understands and can help them feel better. Most are woefully disappointed, see little if any improvement, and are often left feeling hopeless.
So it’s no wonder that patients with fibromyalgia start to have low moods. They start to suffer from anxiety and depression.
The FDA has approved three drugs for fibromyalgia, Lyrica, Savella and Cymbalta.
I wrote a recent blog about the potential pitfalls of taking Lyrica for fibromyalgia. You can read that blog at the bottom of this article.
Savella is similar to Cymbalta, both are antidepressants known as selective serotonin and norepinephrine reuptake inhibitors (SNRIs). These drugs are supposed to help a person re-uptake and use the serotonin (calming brain hormone) and norepinephrine (stimulating brain hormone) more effectively.
The approval of Savella was based on two clinical trials involving 2,084 fibromyalgia patients (1,460 on Savella and 624 on placebo).
About 25 percent of people taking Savella had a positive response. This was considerably better than the 13 percent who had a positive response to placebo.
However, while the maker’s of Savella will be sure to promote it as being twice as effective as a placebo, what they won’t say is what you now know- the drug failed to help 1,095 of the 1,460 participants in the study who were taking Savella.
There are no studies directly comparing Savella to Cymbalta, although it’s likely that because of their similar mechanisms of action they would be similar in effectiveness.
A review of (duloxetine) and Savella (milnacipran) confirms what I’ve said for the last two decades, these drugs are ineffective for most fibro patients, especially long term.
The review published in The Cochrane Library shows that these drugs are ineffective for the overwhelming majority of fibro patients.
The Cochrane Group, is an international organization, whose primary aim is to help people make well-informed decisions about healthcare and health policy by preparing and maintaining high quality systematic reviews. It is a “not-for-profit organization.
Studies show that for fibro patients taking either of the two drugs, 22% report substantial improvement while 21% had to quit taking them due to unpleasant side effects. Almost as many had to quit as had substantial/meaningful improvement.
And when we look at a complicated illness like fibromyalgia, with the diffuse achy muscle pain, insomnia, the fatigue that goes with it a lot of times, the headaches and irritable bowel syndrome, restless leg syndrome-You can’t explain that away as ‘someone is suffering from an antidepressant deficiency’, and expect that just because they go on Cymbalta or Savella, that they are going to start to reverse their fibromyalgia. It just doesn’t happen that way.
I’m not encouraging you to stop your antidepressants. I think that gets people in a lot of trouble, because they don’t know how to do it correctly. Even when they’re working with their doctors, they oftentimes do it the wrong way, and then they think, erroneously, that they need to stay on these medications forever, because if they try to come off of them, they get brain zaps or have withdrawal symptoms and they feel bad. It’s not that they need the medication; it’s the withdrawal symptoms from some of the medication. Patients working with me personally, once they start to feel better on the protocols I recommend for them, are able to slowly wean off their anti-depressants and in 6-8 weeks are off them for good.
And by the way, I don’t think that your fibromyalgia and the symptoms of fibromyalgia are because you’re depressed. I think it’s the other way around. You’re depressed because you’ve got all these symptoms of fibromyalgia, and it’s robbing you of having a life. Most people don’t understand that the fibromyalgia takes away your social life, and any kind of hobby, whether that’s gardening or exercise. It certainly can take away your job, your family life, or your relationship with your spouse. In so many ways it robs you of having a robust life filled with happiness, so it’s no wonder that you would get a little down with fibromyalgia.
The potential side effects of these medications are (1) anxiety, (2) depression. So you take an antidepressant, and it may make you more depressed. That certainly can be the case the longer you’re on the medication.
Headaches, muscle pain – – that’s some of the things that I find with patients. I’m not anti antidepressants. It’s just that, when you’ve got a complicated illness like fibromyalgia, you’ve got to look at all the different variables. Is it something you’re taking or not taking? Is it something you’re doing or not doing? You’ve got to look at these things. Every drug has the potential to cause a side effect. The more drugs you’re on, the more likely you are to have a problem from one of those drugs. That’s just the way it is.
If you’re taking an antidepressant, you need to be aware that it can be causing some of your achy muscle pain. It can cause chest pain. It can cause nervousness. It can cause sleeplessness, or insomnia.
One of the ways it causes trouble with your sleep is it actually depletes your natural sleep hormone, melatonin. So you’re taking a medication and this medication can compromise your ability to get a good night’s sleep. It can make you feel kind of lethargic, it can cause weakness throughout the body, changes in your sex drive so you have a low sex drive, low libido. It can give you tremors, dry mouth, irritated stomach. It can bother your stomach, whether that’s loose bowel movements or constipation. It can cause dizziness, rash, nausea, and weight gain.
Fortunately there is a better way. I’ve helped thousands of patients feel good again. If you’ve not read my book I encourage to do so as soon as possible, it may save your life. Seriously. “Learning to live with fibromyalgia” is a slow, miserable, way to spend what little time we have here on earth. This isn’t living, it’s existing!
You can’t drug your way out of fibromyalgia. Drug therapy alone is a dead end for fibromyalgia. The only way to feel good again and stay that way, is to get healthy. Drugs don’t make you healthy. You can learn how my patients get healthy and feel good again by getting a copy and reading my book Treating and Beating Fibromyalgia and Chronic Fatigue Syndrome. Get a copy to day while it is offered at a discount.
You can read my past blog article about Lyrica and Neurontin by clicking the link below:
These patients and hundreds of others who’ve worked personally with me have in fact beaten their fibromyalgia. You can read or listen to their stories by clicking HERE.