Fibromyalgia - What medications help you with pain, fatigue etc?

I’m also uncomfortable with medications for fibromyalgia, but if you feel really limited, it may at least be worth trying something like gabapentin that’s unlikely to make or break things if you just try a few doses if you start really small. I just wouldn’t do that with Cymbalta because universally my care team has told me they see a higher incidence of discontinuation symptoms. But…I get it if you’re like me and just can’t come around to trying them. I have high sensitivity to medications, and I’m really uncomfortable with the possibility of risks.

I think we’ve exchanged posts before, but I take Low Dose Naltrexone (LDN), and it’s helped with fatigue though I haven’t noticed as much help with pain.

It is hard to find a provider to help manage things, but it does help to at least have a PCP who’s knowledgeable or at minimum is willing to work with you for prescriptions and orders. My PCP works in an integrative medicine clinic and is a DO. All the providers in her office are familiar with and treat fibromyalgia and other chronic pain syndromes, which is nice, but often I ended up bringing things to her. It’s just the way of chronic pain syndromes unfortunately.

I have gotten the most leverage not from medications or physicians but from working with PT and related providers if you can find someone with experience with fibro, chronic pain and central sensitization. If that’s not possible, there are now many resources online or through apps that explain pain neuroscience and how to use that to dampen the pain signals we feel and influence our pain experience. A Mayo PT recommended the app, Curable (it’s a paid subscription but you can do a free trial, or they have a lot of free resources in their site on their blog or podcast to learn more about how chronic pain affects the brain and nervous system and what to do about it) or the book, “Unlearn Your Pain.”

This is a blog post from a PT I’ve referenced before that explains the basics in a shorter format: https://www.activelyautoimmune.com/post/pain-is-it-all-in-my-head

The central sensitization she writes about is the reason physicians prescribe the kinds of medications we’re nervous about—because they change how pain messages are sent or experienced. But the reason I’m bringing this up is because if you really don’t want to go that route, there are other ways to influences those pain messages or adapt that don’t involve medication.

I know your question was about medications, and I’d them, LDN has helped me. But otherwise, I consider PT, OT (occupational therapy) and speech therapy as my foundation or medication. In PT, I learned how to use graded exposure to physical activity and GMI (graded motor imagery), which is used for chronic regional pain syndrome, but it really helped me. In OT, my therapist helped me figure out ways to pace myself, use adaptations to make tasks easier and more accessible for me, and focus on getting me back to things wanted to do. And I just finished a round of speech therapy where my therapist helped me with strategies for managing and improving brain fog and fatigue. It all took longer than medication might have, but it’s what I felt more comfortable with.

You might also be interested in checking out the forum, Inspire. I don’t check the fibro group as much, but the groups are usually moderated by folks with experience with the conditions and in my corner of it, the members are very knowledgeable and helpful and pretty active. I see a lot of posts with people asking for recommendations for doctors depending on where they live and strategies, so it’s another good resource.

I used to use Elavil that worked. It was inexpensive at the time. I read a book that said, "remember three things- exercise, exercise, and exercise. Also stretching makes me feel much better. I have had fibromyalgia for over 30 years.

I have ME/CFR too and exercise can be too much. I'm now in the later stages of both so I'm mainly in fight or flight mode. But you asked about medications so here goes:

Please note, if you are afraid of taking medications, these might not be for you.
LDN is supposed to be good, mentioned above. I'm having a hard time finding here in NJ. Also it has to be compounded and my insurance doesn't cover it.
Most physicians use antidepressants, Elavil is an antidepressant. The ones used most are TCA's. I found them too sedating and made me groggy. They helped with sleep though, I have to admit.
Sleep is crucial in both syndromes. I went to a sleep doctor and found my deep sleep, where your body repairs itself, was being interrupted all night so my body couldn't repair itself from the day's activities. He started me out with over the counter melatonin. When that didn't work, we tried the TCA's mentioned above but as I noted, they left me groggy with a drug " hangover". Finally, we dived into sleep meds like Lunesta and Ambien. I've been on Ambien way beyond it's temporary usage recommended. I haven't had any side effects. It changed my sleep, therefore my life forever. Please find a sleep doctor or have your PC order a sleep study.

To increase energy and not be fatigued, try Provigil ( generic modafinal ).

The heaviest hitters were the opiods, not recommended of course but I'm not an addict, carefully monitored by myself and my pain management doctor.

Please note: I am in the severe category so for mild or moderate symptoms use the beginning meds. I listed them in order on purpose from mild to severe interventions.

I hope this helps. I'm 21 years into this journey. Of course I've done holistic, acupuncture works, OT great, support systems essential. Again, you asked specifically about meds so that's what I focused on. Good luck with your journey! 21 years ago there was no knowledge and no support. We were ridiculed, gaslighted, sent to psychiatrists etc. I survived though I lost family, friends, and my good looks ( lol). Check out support groups. I'm a social worker who believes they are best. We are warriors!

"Heavy" hitters inc

PS typo- it's ME/CFS. Myalgic Encephomylitis/ Chronic Fatigue Syndrome.