New Drug Therapies for Fibromyalgia Pain
Several New Drug Therapies for FM Pain Await FDA Approval
For many years the number of drugs used for fibromyalgia (FM) pain was limited to anti-depressant medication and muscle relaxers. Although effective these drugs were not well tolerated by a number of FM patients. The most frequently used drug was Elavil (amitriptyline) which often leads to increased fatigue, constipation, dry mouth, sexual dysfunction, and weight gain.
Recently, we reported a new treatment of FM pain with Dextromethorphan. This medication is safe and has beneficial effects on the central nervous system amplification of FM pain.
The pharmaceutical industry has recognized the urgent need for additional choices and has several new drugs under development. These medications include Milnacipran, Rotigotine, and Xyrem. During several clinical studies these medications have shown positive effects on FM pain, sleep, and function. They were well tolerated and appear to be safe. Some of these medications have applications pending for FDA approval. If successful these drug would be the second to have a FM indication which makes it easier for practitioners to prescribe these medications. This would also result in coverage of these drugs by HMOs and other insurance companies.
Although one therapy alone only infrequently results in complete resolution of FM symptoms, combination drug therapy or additional therapies like sleep hygiene, physical therapy, stress reduction, and cognitive behavioral therapy (CBT) may be necessary.
Many lines of evidence indicate that FM pain is a chronic process that has led to changes in pain processing of most FM patients but this process is either partially or completely reversible. Like many other chronic conditions, pain therapy requires dedication, discipline, and life style changes. Most importantly, however, it can be done if you set your mind to it!