Prescription or Natural?
Physicians have limited options in writing prescriptions for the pain associated with fibromyalgia. Lyrica and Neurontin (commonly called gabapentin) are the most common prescriptions but often cause side effects. Natural supplements, though helpful, are not regulated which causes concern for patients with a chronic illness like fibro.
As stated on the company’s website, Lyrica is a “prescription medication approved by the US Food and Drug Administration (FDA) and is used in adults to treat fibromyalgia, diabetic nerve pain, or pain associated with diabetic peripheral neuropathy and pain after shingles.
How Lyrica works remains a mystery. The manufacturer says “Lyrica is believed to work on damaged nerves, or calm overactive nerves, depending on your condition. It is unknown exactly how Lyrica works in the body. However, certain studies suggest that Lyrica reduces ‘extra’ electrical signals sent out by damaged nerves in the body."
The most common side effects, according to the FDA, are dizziness, blurry vision, weight gain, sleepiness, dry mouth, trouble concentrating, and swelling of the hands and feet. Severe adverse reactions can occur as well, and this can include swelling, blistering, trouble breathing, worsening muscular pain, soreness or weakness, and fever. Every once in a while in about 1 of 500 people, Lyrica can alter moods and increase suicidal thoughts or actions, as well as anxiety, depression, or aggression.
Lyrica belongs to a class of drugs known as anticonvulsants. Drugs like Lyrica work by effectively reducing the pain signals released by damaged or affected nerves. Suddenly stopping Lyrica or drastically decreasing the dose can lead to uncomfortable withdrawal symptoms. In some cases, these withdrawal symptoms can become life-threatening and require medical care.
Neurontin, or Gabapentin, is usually used to treat postherpetic neuralgia, the nerve pain that sometimes occurs after shingles and epilepsy. It is not FDA-approved to treat fibromyalgia, but doctors will still sometimes prescribe it to their patients in hopes it will alleviate some of the shared symptoms. Unfortunately, Neurontin carries some of the same side effects as Lyrica and in some instances may hold even worse consequences.
While the positive results from the medicine for helping fibromyalgia are not fully known, the evidence weighs in relatively heavy on its potential side effects. According to the data from the FDA, Neurontin can cause a variety of adverse reactions, but the most common ones are dizziness, sleepiness, loss of muscular control or coordination (ataxia), and involuntary eye movements. Though relatively uncommon, other potential side effects range from uncomfortable to severe, including dry mouth, headaches, tremors, viral infection, weight gain, and fever.
Other Possible Considerations
Christine Lynch offers her experience dealing with fibromyalgia personally in her article “Research the Medicines; Make a List” on Fibromyalgia News Today. In addition to the commonly considered consequences of taking medication, she also warns that certain elements in the medicine other than the active ingredients may be factors in making a decision, “If you’re as sensitive as I am, the brand can make a difference. Although the active ingredient in a generic drug must be the same as in the brand name, dyes, fillers or coatings may differ widely from one manufacturer to another. For example, I cannot tolerate the gelatin used as the shell for many capsules. Instead, I specify an organic drug with a capsule made from cellulose” (Lynch).
In all cases, she recommends making a list of every medicine or supplement you’ve taken and include any allergies/adverse reactions and the duration and dosage. She would usually carry her list to the doctor’s office, and it would aid both her and her doctor in deciding which treatments may or may not be worth the risk.
She gives particulars for what to include in the list, saying, “If you have allergies to any medications, foods or herbs, be sure to list those first. Include the name of the drug you took and whether it was a brand name or a generic. If it was generic, also record the manufacturer’s name…Also be sure to include the dose you took and why you took it. Later, you might consider a much higher or much lower dose for a different symptom. It also is helpful to record the date. Negative drug reactions may be linked to life factors such as stress, hormonal status or other drugs in your system at that time. Lastly, you’ll want to record the length of time that elapsed before side effects first appeared. All this information is useful in knowing what to expect in the future” (Lynch).
Alternative Remedies and Valuable Input from Consumer Labs
Endless opportunities outside of prescription medicine are available as potential treatments for fibromyalgia, including natural supplements. However, as Christine warns, all of them do not necessarily deliver what they promise, “Without government regulation, bottles of supplements don’t necessarily contain what the labels say they do” (Lynch).
Known alternative treatments to alleviate the symptoms with few or no side effects include yoga, massage therapy, acupuncture, eating well, cutting out caffeine, aspartame, or gluten, and aromatherapy. Only through trial and error will a fibro patient find what eases their symptoms.
Consumer Labs: https://www.consumerlab.com/index.asp
FDA Medication Guide on LYRICA: https://www.fda.gov/downloads/Drugs/DrugSafety/UCM152825.pdf
FDA Data on Neurontin (gabapentin): https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/020235s036,020882s022,021129s022lbl.pdf
Fleming, Kevin C. “Fibromyalgia Treatment: Is Neurontin Effective?” Mayo Clinic, Mayo Foundation for Medical Education and Research, 16 Aug. 2017, www.mayoclinic.org/diseases-conditions/fibromyalgia/expert-answers/fibromyalgia-treatment/faq-20058273.
Dix, Robin. “Fibromyalgia, Essential Oils, and You.” Fibromyalgia News Today, 21 Sept. 2016, www.fibromyalgianewstoday.com/blog/2016/09/20/fibromyalgia-and-essential-oils/.
Lynch, Christine. “Making the Case for Creating a Fibromyalgia Medicines List.” Fibromyalgia News Today, 5 Oct. 2017, www.fibromyalgianewstoday.com/2017/10/04/fibromyalgia-making-case-for-creating-medicines-list/.