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Johns Hopkins Health Alert

New Option for Fibromyalgia Treatment

If you have fibromyalgia, you know that getting plenty of sleep and regular exercise are extremely important. While treatment options for the pain and fatigue of fibromalgia are limited, two recently available medications offer hope.

The treatment of fibromyalgia involves managing the symptoms. Drugs typically used include antidepressants, pain relievers, sleep medications, muscle relaxants, anti-anxiety agents, antiseizure medications, and medications used to control headaches.

Last spring, the FDA approved pregabalin (Lyrica) for the treatment of fibromyalgia. In clinical trials, Lyrica reduced pain of fibromyalgia better than placebo. This medication is also approved to treat neuropathic pain (pain from damaged nerves) in people with diabetes and pain in people who have had shingles (postherpetic neuralgia). It is also used to treat certain types of seizures.

Recently, results from a 12-week study reported in the journal Arthritis & Rheumatism (Volume 56, page 1336) suggest that the epilepsy drug gabapentin (Neurontin) could offer some relief. The researchers randomly assigned 150 individuals with fibromyalgia to take gabapentin (1,200–2,400 mg) for 12 weeks or placebo (inactive) pills. They found that compared with placebo, gabapentin significantly reduced pain and fatigue and improved the quality of sleep, as measured by several standardized tests. In fact, more than 50% of the gabapentin group reduced their pain severity score by at least 30% compared with only 31% of those taking placebo.

Currently, the FDA has not approved gabapentin for the treatment of fibromyalgia. However since Lyrica has a similar mechanism of action, you could ask your doctor about trying it for your fibromaylagia pain and fatigue.

Posted in Arthritis on March 23, 2009
Reviewed July 2009

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Health Alerts registered users may post comments and share experiences here at their own discretion. We regret that questions on individual health concerns to the Johns Hopkins editors cannot be answered in this space.

The views expressed here do not constitute medical advice, and do not represent the position of Johns Hopkins Medicine or MediZine LLC, which has no responsibility for any comments posted on this site.


I tried Lyrica last year for fibromyalgia, which I have had for about ten years. It does sound good, and worth a try. However; It is a drug, and all drugs have side effects. I had to stop taking Lyrica because it affected my mood. I became irritable at first, then emotionally numb, and finally I began zoning nearly all time. I did not talk unless I was asked a question. I simply did not care about anything at all. My Doctor felt I was heading towards suicidal ideation. I felt better with-in 2 days after I stopped taking it. My current medical issues might have played a part in my reation. I have complex Post Tramatic Stress Disorder and abused Child syndrome, both of which are a result of 42 years in abuse. I take medication of course, and am working through the issues caused by my past. I do have a lot of self honesty, and have studied Psycology, Neurology, and some sociology most of my life in-order-to understand the life I was born into. So, I am very intouch with changes in my moods. I tell you that so you know I am not un-informed, nor am I just complaining. Lyrica does help many people, but it is nothing to play with. Be watchful of changes in your mood if you decide to take it. You are the only one who can really say how a medicine is affecting you. The Labs that make all drugs are companies in business to make money, remember that. I am not saying I know the makers of Lyrica are pushing a bad drug, but they are not Psycologists either. just be careful. I have found relief from Cymbolta at 90 mg. a day. I also take Magnesium, which helps. Don't give up looking for solutions, and you will find them. Ciao

Posted by: kam-A voice from the bottom | March 28, 2009

Gabepinton and Gabatrel (sps?) both caused me to have panic attacks after just a few days.

When I was put on Lyrica, I couldn't believe how much it helped. After a few months, I began to develop a weakness that made it very difficult to get out of a chair, without something to pull or push upon. I read the really fine print of the info sheet, and found the statement that it can cause muscle weakness.

I stopped it and after a few days, started getting much stronger.

A pharmacist friend told me to try 100 mg of vitamin B1 - every day. He said it might take a month to see the difference. I just got B100, and it really has helped. I still have some problems during these changes in the weather, but all in all, I do think I'm better.

Posted by: quilts4you | March 28, 2009

Greetings, Of those that have tried the drug, have any of you experienced problems with disturbing thoughts or ideas? I took Lyrica for over a month for chronic neuro-muscular pain in conjunction w/ other pain meds [MS Contin 60 mgm (BID), Oxy IR 5 mgm (PRN breakthru pain)] and HBP med [Cozaar 100 mgm]. Around the 10th day, I noticed a marked change in the type of dreams (more violent) and entering the third week, thoughts of violence towards strangers. After speaking w/ my doctor, he d/c the med and said that some abnormal thoughts were an "uncommon" side effect but noted in the literature. I was not under any undue stress at the time, nor did I experience any change in sleep habits, or any other stressor(s) that might suggest any underlying psychiatric condition. Since d/c, I have not had any violent dreams or thoughts. My doctor is believes that it was a result of the medication. Regardless, I was not on the medication long enough to determine its effectiveness in lowering my pain. Has anyone experienced anything similar? I would hate to think there is medication that might alleviate or lower my pain, but not take it b/c of these thoughts that might only be a temporary side effect.

Posted by: legman | March 28, 2009

When I called the study on Gabapentin to the attention of my rheumatologist she said it helped only with peripheral nerve pain and not the muscle pain of fibromyalgia. I have been on Gabapentin for over 4 years but dosage has never exceeded 900 mgs/day. I'm not even sure it helps with muscle pain but when I have tried to quit it a few times in the past, I seemed to feel worse. I'm interested in hearing from people who have taken Gabapentin in dosages from 1200 to 2400 mgs/day and whether or not it has helped them with muscle pain and/or restorative sleep.

Posted by: rldsodak | March 28, 2009

I,too, was diagnosed with Fibromyalgia. I was treated for this complex disorder for nearly 10 years, enduring all of the painful symptoms.

I was referred to a website, SweetPoison.com, where I learned about Aspartame poisoning that mimics Fibromyalgia and a host of other disorders. I eliminated aspartame from my life and am happy to report that I have been symptom free (and medication free) for the past year. It is tricky to find all of the sources of this harmful substance. Even some vitamin supplements contain aspartame. For me, the big culprit was diet coke!!

It certainly won't hurt to check this out. There are NO side effects to eliminating substances from your body.

Posted by: bacoyle | March 28, 2009

I have tried lyrica and it comatosed me. I was only on lowest strength for three days and could not handle it. I know meds take time but I need to work and couldn't taking lyrica. I also had the gabe? and basically same thing. I take cymbalta in am and pm different strengths and ativan. The pain level is always high for me. They really need to find something for people who can't tolarate meds well. I know asking alot but I am ready to quit job and try for disability cause too much pain and too many other things now happening to me. Very depressed with my health right now.

Posted by: martyj | March 29, 2009

My pain management specialist put me on Neurontin for nerve pain a few years ago. I've worked up to 800 mg and I've been lucky enough to be able to tolerate it (she says I'm one of a few of her patients who can). A few months ago, she noticed that I seemed stiff and sore. She checked all the fibro trigger points and sure 'nuff. I tried weening down the dose of Neurontin a couple of weeks ago and noticed that the hurt I feel all over got worse when I did. I'm back on the 800 mg. and feel better.

Posted by: ctrexler03 | March 31, 2009

I also took neurontin and Lyrica for fibromyalgia. Both made my mouth get red and raw. I know that it was the meds because I stopped taking them and it stopped. When I restarted the meds, my mouth got red and raw again. It hurt to drink a carbonated drink even. The best thing I have found is what I am on now--nortriptyline. I take a 50mg capsule at night. I was on oxycontin 40mg 3 times a day and now I am on Percocet 10/325mg 3 times a day as needed. Sometimes I only need 2 a day. Amitriptyline also worked but it made me drowsy and just felt bad. I tried all the new meds that came out without help until my new internal med doctor tried me on the amitriptyline and then the nortriptyline. I felt better in about 3 days. If you haven't found anything to help ask your doctor if he/she will let you try one of these meds.

Posted by: zsazsa55 | April 3, 2009

Hi, I have fibro (was diagnosed 9 years ago) and have tried all sorts of drug cocktails over the years as I'm sure you'll all appreciate. I have been on 600 mg Pregabalin a day for a year now and am currently weaning off it in an attempt to identify "what works" and t find out what is causing my sudden weight gain and ureology problems. I have experienced several off the side effects already mentioned including the violent dreams, sore mouth and others, but have to say I am finding that coming off this drug is hell! The neurologic pain is excruciating and I feel awful, at the present moment (half way through the weaning process)I'm really not sure if giving it up is a good idea .

I am booked in for a lithocain infusion late this month and wondered if anyone else had tried this?

Posted by: JayneL | April 6, 2009



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