Fibromyalgia is a neurological condition that causes chronic and widespread pain and tenderness, according to the American College of Rheumatology. It is not an autoimmune disease—meaning the pain is not caused by inflammatory attacks on the body—and it’s not a joint or muscle disorder.
Instead, fibromyalgia is linked to the central nervous system, such as the brain and spinal cord. Due to the complex causes of fibromyalgia, treatment needs to be multifaceted to be effective.
“Treatment for fibromyalgia is comprehensive,” says Anita Gupta, DO, PharmD, pain specialist. “Individuals require physical therapy, cognitive behavioral therapy, and medication treatment. This can help patients recover fairly rapidly.”
Of course, a good medication for fibromyalgia must be able to reduce pain. Additionally, other goals for fibromyalgia medication are to improve functioning and quality of life.
“Individuals who don’t respond to physical therapy, diet, exercise, and lifestyle modifications typically are given medications to treat their pain,” says Dr. Gupta. (Learn more about lifestyle changes for fibromyalgia here.)
There are two main classes of FDA-approved medications for fibromyalgia: anticonvulsants (or anti-epileptics) and antidepressants. Both of these work on neurotransmitters in the brain.
“These neurotransmitters are believed to increase the pain sensations that fibromyalgia patients have,” says Dr. Gupta. “By modulating how they work, patients who have fibromyalgia have decreased pain sensations and hopefully feel less pain overall.”
For example, doctors may prescribe the antidepressant serotonin norepinephrine reuptake inhibitors (SNRIs) to treat fibromyalgia symptoms. This type of antidepressant helps increase neurotransmission that blocks pain signalling, according to the Arthritis Foundation.
“The results of the medication vary patient to patient,” says Dr. Gupta. “For the most part, patients do respond to the medications, and with comprehensive treatment—between the physical rehabilitation, cognitive behavioral therapy, good lifestyle modifications, and the medications—patients do overcome their illness.”