Title : Fibromyalgia - brand-new Treatments
Fibromyalgia (FM or FMS) is usually a condition which causes chronic musculoskeletal pain. Besides widespread pain the idea is usually characterized by tender points, painful areas located in certain parts of the Centeng. There are often various other symptoms as well, such as fatigue, headaches, cognitive problems, sleep disturbances, anxiety along with also depression.
People with fibromyalgia frequently have various other comorbid illnesses, such as chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), migraines, restless legs syndrome (RLS) along with also irritable bowel syndrome (IBS). Fibromyalgia commonly occurs together with autoimmune diseases, especially rheumatoid arthritis along with also lupus (SLE), although the idea is usually not thought to be an autoimmune illness. The exact mechanism which causes the illness is usually not fully understood yet.
Lyrica along with also Cymbalta
The FDA has approved two medications for fibromyalgia: pregabalin (Lyrica) in June 2007 along with also duloxetine (Cymbalta) in June 2008. Pregabalin is usually an anticonvulsant (epilepsy drug), though the idea is usually used more often for pain disorders. Duloxetine is usually an SNRI antidepressant (serotonin along with also norepinephrine reuptake inhibitor), also used for diabetic neuropathy along with also stress incontinence.
Despite being in entirely different classes of drug, both Lyrica along with also Cymbalta can help pain, sleeping problems, fatigue, cognitive impairment, depression along with also anxiety caused by fibromyalgia, though they don't help everyone along with also even if you do benefit, you might not get improvement in all of the listed symptoms.
various other Similar Drugs
The drug companies behind these drugs might of course like us to believe they are the magic bullets, although luckily there are many various other medications which can help fibromyalgia. The manufacturers of most various other drugs just haven't invested from the expensive trials needed to gain FDA approval -- often because the patent is usually going to expire soon along with also after which their benefits will drastically drop.
For example, gabapentin (Neurontin) is usually an anticonvulsant very similar to Lyrica, which used to be widely prescribed for fibromyalgia, although today Lyrica has surpassed the idea. The drugs have almost identical modes of action. There is usually no clear evidence showing which either one is usually more effective. Some people can tolerate pregabalin although not gabapentin, along with also vice versa. Neurontin comes using a bit cheaper cost tag.
Duloxetine is usually not the only SNRI antidepressant either. Venlafaxine (Effexor) is usually also an SNRI, though in low doses the idea does not have which much effect on norepinephrine. Milnacipran (Ixel) is usually a promising SNRI antidepressant which is usually not yet available from the United States, although is usually sold in most of Europe. the idea has shown not bad results in preliminary fibromyalgia trials. the idea is usually also very inexpensive along with also thought to be one of the best tolerated antidepressants.
Anticonvulsants along with also Antidepressants
Generally almost all anticonvulsants, including older names like carbamazepine along with also lamotrigine along with also newer players like topiramate, zonisamide along with also levetiracetam can help the symptoms of fibromyalgia. There are big differences in modes of action among drugs in This specific class, so even if one does not work or produces intolerable side effects, another one might be worth a try. They tend to be especially helpful for pain, mood problems along with also migraine prevention, often also for sleep.
The same goes for antidepressants, too. The reason they are used in fibromyalgia is usually not which fibromyalgia is usually a psychiatric disorder, although they are also used in many various other painful conditions like migraines, chronic headaches, neuropathic pain along with also IBS. the idea is usually thought which fibromyalgia may be associated using a deficit of serotonine along with also norepinephrine.
The SSRI antidepressants like fluoxetine (Prozac) are generally not so effective for pain. Many various other antidepressants, however, also affect norepinephrine. These include tricyclic antidepressants such as amitriptyline (Elavil) along with also imipramine which have been used to treat fibromyalgia since the 1980s. They are used in very smaller doses, usually much smaller ones than might be used for depression. They are especially effective for sleep, although often cause too many side effects.
NMDA Antagonists
A third promising class of drugs is usually NMDA receptor antagonists. The NMDA receptor is usually thought to be overactive in fibromyalgia along with also downregulating the idea could relieve all symptoms of the condition. NMDA antagonists include the cough suppressant dextromethorphan, amantadine which is usually used for influenza along with also Parkinson's disease, the Alzheimer's drug memantine along with also riluzole, a brand-new drug used for amyotrophic lateral sclerosis (ALS).
various other drugs which also downregulate the NMDA receptor include e.g. calcium channel blockers, many anticonvulsants, some opioids (methadone along with also dextropropoxyphene) along with also the muscle relaxants dantrolene along with also orphenadrine. Magnesium along with also the amino acid taurine may also have This specific effect.
Hormonal Treatments
Fibromyalgia has also been associated with endocrinological (hormonal) deficiencies, especially of growth hormone, thyroid hormone along with also vitamin D, which is usually nowadays considered a steroid hormone. Others, such as estrogen, testosterone along with also cortisol have also been suggested as culprits.
Growth hormone has been shown to be deficient in a subset of people with fibromyalgia along with also supplementation helps many people. Unfortunately the treatment has to be given as an injection along with also is usually very expensive. Luckily some oral drugs can also boost growth hormone secretion, such as the anti-anxiety drug buspirone, the blood pressure drug clonidine along with also the muscle relaxant baclofen. Melatonin may also have This specific effect.
Some doctors believe which thyroid supplementation can even completely relieve fibromyalgia symptoms in some cases where laboratory results are supposedly normal. On the various other hand many patients have reported excellent results, even complete pain relief with large doses of vitamin D.
Promising Drug Candidates
Many drugs are currently in clinical trials for fibromyalgia. Sodium oxybate (Xyrem) is usually a sleep aid which can also help depression along with also pain. the idea is usually currently approved for narcolepsy, although is usually used off-label for severe insomnia. Several trials have demonstrated not bad efficacy in fibromyalgia, although insurance companies are likely to frown at the cost.
Flupirtine (Katadolon) is usually used in many European countries for e.g. low back pain. the idea has some NMDA blocking properties along with also has shown not bad efficacy in preliminary trials. If clinical trials are successful, the company is usually planning to market the idea for fibromyalgia with the brand name Effirma.
Lacosamide (Vimpat) is usually an anticonvulsant using a novel mode of action. the idea is usually not yet on the market, although may be approved from the United States along with also Europe before the end of 2008. A recent phase IIa trial concluded the idea was effective along with also well-tolerated in fibromyalgia.
Low dose naltrexone (LDN) is usually a treatment which increases the secretion of endorphins, our natural painkillers. Fibromyalgia may be associated with an endorphin deficiency, which could also contribute to fatigue, depression along with also various other symptoms. A clinical trial trying LDN for fibromyalgia is usually currently running in United States.
Fibromyalgia - brand-new Treatments
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