Pregabalin (Lyrica), duloxetine (Cymbalta), and milnacipran (Savella) are approved specifically for treating fibromyalgia. However, many other drugs are used to treat the condition, including antidepressants and muscle relaxants. There is no consensus over which treatment is most useful, or whether a combination of treatments works best. The goal with medication has been to improve sleep and pain tolerance. Medications from other drug classes (such as sleeping aids and pain relievers) may also be prescribed. Patients receive drug treatments in combination with exercise, patient education, and behavioral therapies.
Anti-Seizure Agents (Anti-Convulsants)
Pregabalin is an anti-epileptic medicine. Also called anti-seizure drugs and anti-convulsants, these medicines affect the chemical messenger gamma aminobutyric acid (GABA), which helps prevent nerve cells from over-firing.
Research is indicating that pregabalin may improve sleep quality, fatigue symptoms, and fibromyalgia pain. One study found that three different doses of pregabalin -- 300 mg, 450 mg, and 600 mg -- were effective at improving pain and sleep, and all were well tolerated by patients. The most common side effects include mild-to-moderate dizziness and sleepiness. Pregabalin can impair motor function and cause problems with concentration and attention. Patients should talk to their doctor about whether pregabalin may affect their ability to drive.
Studies have shown that another anti-convulsant, gabapentin (Neurontin), which is approved for the treatment of postherpetic neuralgia, affects pain transmission pathways and may relieve pain associated with fibromyalgia. Patients who took gabapentin have reported that they slept better and were less tired.
Review Date: 12/27/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.