To Drug or Not to Drug…

I recently joined a couple fibromyalgia support groups on Facebook – hi everybody, just in case you’re reading.  Reading about their experiences has really brought to home how different everyone’s experiences with fibromyalgia are.  Symptoms and severity are wide-ranging, as is the effect on the quality of our lives.  One common denominator I see in the posts, however, is the question about drugs.  Which drugs have worked, which supplements to take?  It’s the natural question.  We have been taught that there should be a pill to make it all better.  With fibromyalgia, however, that may not be the case.

In particular, there are studies indicating that opioids not only are ineffective, they may have a detrimental affect on people with fibromyalgia (see Goldenberg in the library). There are several drugs that are being advertised as beneficial for patients with fibromyalgia, but the evidence (from non-biased research studies) is very minimal that they have a true benefit.  The only drug I have read about that may be effective in actually treating fibro is pregabalin, and that is because, theoretically, it actually rebuilds bits of the brain that have been affected by chronic pain (see library, Klein et al, and various studies about the effect of chronic pain on the brain).  While antidepressant use is likely a necessity for people with chronic pain, I can’t find any evidence that indicates that they do more than help with depression and possibly suppress a little superficial pain.

At the same time, there is growing evidence that genetics plays a fairly large role in fibro (see library by subject – Genetics).  With genetics playing a role, there is a strong possibility that people with fibro may react differently to drugs than other people.  I’ve discussed before that I had to undergo genetic testing to see why I was unable to take so many antidepressants.  Three of the four metabolic channels that were tested were determined to be defective, one completely unusable.  This not only explained my problems with drugs (I’m allergic to several antibiotics, as well, including penicillin – case in point, major heartburn with the antibiotic I’m on right now), but also my problems with caffeine and nicotine.  I have wondered, but not have been able to find studies to answer the question, if people with fibro have similar metabolic deficiencies and whether these deficiencies are caused by chronic pain or if they are the cause of chronic pain.

One drug, Cymbalta, has really been pushed as a great drug for people with fibro because it is supposed to help with pain and depression both.  I went on it for about 3 months, until my insurance changed and I just couldn’t pay for it.  I was amazed when I went off the Cymbalta.  There was some relief of pain while taking it, possibly more than I realized, but the real effect of Cymbalta was to suppress my brain.  I didn’t realize it, but I was half asleep the entire time I was taking it, like I was sleeping under a heavy blanket.  When I stopped taking it, my brain woke up, and it was like seeing daylight after a long sleep, like breathing again after being stuffed up by a cold.  My creative juices suddenly started to flow again and I felt so free.

It’s a balancing act, like everything about fibromyalgia, and it’s important to make choices, sometimes really hard choices.  My only suggestion is to look at some of the studies about drugs and fibro before really putting your hopes on a magic pill to return your quality of life.



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