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SSRIs for Fibromyalgia

Fibromyalgia syndrome is a chronic disease of widespread pain whose cause is still unknown to this day and whose risk factors are poorly understood. It is often connected to rheumatoid and other pain disorders as well as psychiatric disorders such as anxiety and depression. Although they are not officially approved, antiepileptics and antidepressants are often used to treat fibromyalgia. Because of the poor tolerability of the tricyclics, the newer antidepressants have been widely tested in fibromyalgia. The selective serotonin reuptake inhibitors (SSRIs) and the reversible monoamine oxidase inhibitors seem to be helpful on some level.

On the other hand, the serotonin and norepinephrine reuptake inhibitors (SNRIs), duloxetine and milnacipran have been shown in placebo-controlled trials to offer significant relief to patients suffering from fibromyalgia. Although no direct comparative studies have been performed, these compounds appear to be as effective as the TCAs but much better tolerated. The effectiveness of the SNRIs as well as other dual acting antidepressants, such as mirtazapine, implies that a dysfunction of both serotonin and norepinephrine neurotransmission probably exists in fibromyalgia. The effectiveness of antidepressants appears to be independent of their effect on comorbid depression.

Selective Serotonin Reuptake Inhibitors (SSRIs)

SSRIs are one of the newer classes of antidepressants. They are most commonly prescribed for depression as well as a variety of other ailments. SSRIs work by stopping the breakdown of serotonin in the brain. Serotonin is a neurotransmitter, which helps our brain to communicate pain signals and emotions. SSRIs are highly effective at reducing feelings of depression and anxiety.

SSRIs are also used in fibromyalgia in order to improve sleep patterns. People with fibromyalgia very often have disturbed sleep, which contributes to fatigue and pain. SSRIs also help to bolster mood in fibromyalgia patients. Commonly prescribed SSRIs include fluoxetine, paroxetine, and citalopram. They are usually not effective for pain relief and therefore are not used as often as TCAs. Recent research shows that SSRIs are most effective when used in combination with a TCA. Thankfully, side effects of SSRIs are mild. This antidepressant’s drug side effects include nausea, weight gain, anxiety, and headaches.

The Study

Researchers conducted a review of research about the effects of antidepressants classified as serotonin reuptake inhibitors (SSRIs) on fibromyalgia. After searching for all relevant studies, they found seven studies that compared SSRIs with a fake medication. These studies included a total of 383 people and most participants were middle-aged women. The SSRIs that they studied were citalopram, fluoxetine and paroxetine. Five studies were each funded by pharmaceutical companies, and two studies were funded by public institutions.

Key results

Researchers are still uncertain of the evidence of the outcomes of reduction of pain, sleep problems, fatigue, depression, global improvement tolerability and safety. Possible side effects of SSRIs may include dry mouth, nausea/vomiting, and sexual dysfunction. Rare complications may include allergies, diseases of the immune system, and impairment of a person’s ability to drive or operate machinery. Serious side effects, such as suicidal thoughts and liver failure, are very rare.

Experts to this day do not know exactly how SSRIs work to improve fibromyalgia. But some people with fibromyalgia who take SSRIs seem to have improved mood and less fatigue. These medicines are a type of antidepressant and doctors also prescribe them to treat depression. Doctors may prescribe SSRIs when mood problems are a major symptom of fibromyalgia because SSRIs seem to improve mood and may help relieve pain and sleep problems.

Medicine is one of the many tools your doctor has in order to treat a health problem. Taking medicine will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health at risk. There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do.