Have you ever had so much chronic pain in your muscles that you feel depressed? This is one way to describe fibromyalgia, but it is not as gentle as you might think. We will get into it shortly.
In the past decade, we have seen very many medications that have been screened to treat fibromyalgia. Some of the medications include corticosteroids, relaxants, sedatives, NSAIDs ( Non-steroidal anti-inflammatory medications) and tricyclic antidepressants.
There is some history in the use of tricyclic antidepressants to treat fibromyalgia. It is not a surprise that some antidepressants like amitriptyline, doxepin, and nortriptyline are given to patients who have fibromyalgia. Although amitriptyline is the most popular drug to treat fibromyalgia. But what is fibromyalgia?
What is fibromyalgia?
Fibromyalgia is a chronic disease that causes extensive musculoskeletal pain. We still don’t know what causes fibromyalgia, but some of the symptoms include:
- Painful tender joints
- Insomnia
- Depression
- Fatigue
- Twitching and muscle pain or tightness
Even though there is no known cure, a combination of medication and therapies like stress management, exercise, healthy living habits and medication can ease off the symptoms for an active life.
What is amitriptyline?
Amitriptyline which is also known as Elavil is a TCA drug used to treat depression symptoms. It can also be used in the treatment of chronic neuropathic pain and fibromyalgia.
Amitriptyline is used to increase the natural substance that controls the brain’s mental balance. It is also the most popular TCA drug that is frequently prescribed for patients suffering from fibromyalgia.
Fibromyalgia and Antidepressants
The most common fibromyalgia medications that are used to treat the symptoms include sleeping pills, antidepressants, and painkillers.
Since antidepressants are the most common fibromyalgia medications, they have been used for years by many patients. The category of antidepressants we are talking about is the tricyclic antidepressants (TCA).
According to Boostmood, TCA medications have been used over the years to boost levels of neurotransmitters and brain chemicals. When there is a boost in the level of neurotransmitters, the brain is prevented from getting any impairment in its natural function.
Neurochemicals like norepinephrine and serotonin are boosted by these antidepressants. People who have chronic pain usually feel better after taking these antidepressants.
TCA is also an important player in relieving pain from the muscles. The body’s natural painkiller, known as endorphins are also boosted by TCA.
Although there are positive results with medications on fibromyalgia, the side effects that come along with these medications can make it tough for anyone to stick to the drug on a regular basis.
Some of the TCA medications that are prescribed for fibromyalgia include milnacipran, duloxetine, and venlafaxine. According to the FDA, milnacipran and duloxetine are approved as medications for fibromyalgia.
On the other hand, venlafaxine has not been well researched to be recommended as a proper medication. There are other antidepressants that have been recommended as medications for fibromyalgia, they include:
- Fluoxetine
- Paroxetine
- Citalopram
Is Amitriptyline a good drug for fibromyalgia?
According to Dr. Andrew Moore of the University of Oxford and his associates, they concluded through a research that TCA drugs have a much stronger effect on fibromyalgia, compared to placebo drugs. Controlled studies have been done, and the results have shown that amitriptyline improves stage 3&4 sleep disorders.
Additionally, the studies have highlighted that people suffering from fibromyalgia experience pain relief after using Amitriptyline.
The study that was take comprised of 70 fibromyalgia patients, who were provided with 50 mg of Amitriptyline. These patients showed a considerable change in their quality of sleep after a few days.
These patients woke up without morning stiffness, they experienced less pain and they had a general improvement on how they felt throughout their body. Although the improvements were several, the tender point score did not change.
After Amitriptyline was taken, it had some side effects to the patients which included:
- Confusion
- Urinary retention
- Morning sedation
- Dry mouth
After the study was done, it was concluded that the medication needs to be personalized, so that change can be experienced at the maximum level after understanding someone’s physical capacity and extent of the condition.
Dosage of Amitriptyline
When the drug is administered one or two hours before bedtime, you can minimize feelings of hangover or morning sedation. If a response is not noted, then an increase of the dose can be done after two weeks.
Seven random trials were tested on the efficacy of amitriptyline as a fibromyalgia treatment. It was discovered through the study that 25 mg of amitriptyline a day in six trials resulted in a therapeutic response, compared with a placebo drug that didn’t have that much of an effect, after being induced in the domain of sleep, pain, and fatigue.
After six to eight weeks, the treatment seemed to benefit the patient, but after twelve weeks, there was no effect at all. After 50 mg of amitriptyline prescription, a day trial test in four random people was made, but there was no therapeutic effect witnessed.
After the trials, there was no effect of neither 25 mg or 50 mg of amitriptyline on tender joints