Presently, no single medication alleviates all of a fibromyalgia patient's pain and accompanying symptoms. This makes it doubly important for physicians to keep updated regarding results of ongoing FMS research and current changes in recommended fibromyalgia treatments.

Before medications are prescribed for a patient, it is the responsibility of the attending physician to elicit a comprehensive medical history. Because different symptoms accompany each FMS patient, the doctor needs to know what problems are specific to each individual. For instance, non-restful sleep is almost always a major concern for fibromyalgia sufferers. Small doses, usually 10 mg, of antidepressant medication seems to help many FMS people. However, if after taking a detailed history, the physician discovers a pattern of sleep myoclonus (nocturnal leg jerks) medication such as Klonopin or Sinemet at 10-100 mg might be a better choice.

It is important for the physician to encourage the patient to keep a detailed written journal of medications, dosages, timing and side effects. This written record will be beneficial to the patient as well as the doctor when prescribing medication.

It takes time and communication between the health care professional and patient to determine the correct FMS medication, proper dosages, and appropriate time to take the prescriptions.

Information on Alternative Treatments is also available.

• Tricyclic Anti-Depressants
• Benzodiazepines
• Serotonin-Boosting Medications
• Muscle Relaxants
• Analgesics
• Other Medications

Flexeril (Cyclobenzaprine) dose is usually 10 to 30 mg per night. A tricyclic drug similar to Elavil with muscle relaxant qualities. May be taken along with Elavil to provide muscle relaxant relief. This medication usually reaches its maximum effect after one to two weeks of continuous use.

Sinequan (Doxepin) a typical dose is 2.5 to 75 mg. Also a tricyclic that functions in the body as an antihistamine. Available in tablet form as well as liquid.

Pamelor (Nortriptyline) the usual dose is 10 to 50 mg per night. Similar effects as Elavil but may be less sedating.

Desyrel (Trazodone) the usual dose is 25 mg to 50 mg per night. Desyrel is as effective as the other anti-depressants, however, is chemically different and may be less likely to cause side effects. Desyrel is a mild stimulant and may make a sleep problem worse if combined with a tricyclic anti-depressant at night.

Many of the tricyclic anti-depressants have side effects that may be intolerable for some people. These include constipation, drowsiness, dry mouth and eyes, headache, heart rate abnormalities, increased sensitivity to sunlight, morning "hangover," and weight gain. These side effects may improve after patients have been using the medication for a few weeks. If not, the doctor should be consulted regarding another medication.

Klonopin (Clonazepam) 0.5 to 1 mg at night is helpful in sleep myoclonus (arm and/or leg spasms). Klonopin may help patients who grind their teeth. It stays active in the body longer, and has the same possibility of being addictive as Xanax, and may cause depression in some people.

The anti-depressant and anti-anxiety properties of these medications can cause the following effects: Depression, drowsiness, impaired coordination, impaired memory, muscular weakness and/or concentration problems, and they are known to be addictive.

Paxil (Paroxetine hydrochloride) the usual dose is 5 to 20 mg in the morning.. This medication is the most potent of this type. A sedating medication may be needed at night in conjunction with Paxil. It can cause nervousness, insomnia, nausea, sexual difficulties and sweating, although many patients report having fewer side effects with Paxil as compared to Prozac.

Zoloft (Sertraline) 50 to 200 mg is the usual dosage. Anecdotally proven helpful for some patients. Sedating medication may also be needed to combat insomnia.

Serzone (Nefazodone) is the newest of these agents. As well as increasing serotonin, it also increases norespinephrine. Serzone's efficacy and side effects are similar to Effexor.

Effexor (venlafaxine hydrochloride) the usual dose is 27.5 mg two times per day. This dosage can be adjusted, depending on the effects. Effexor is not related to the tricyclics or the Prozac-like drugs, however, it does boost serotonin and has tricyclic properties. The typical side effects are nervousness, anxiety, insomnia and increased blood pressure.

The following are some of the side effects of serotonin boosting medications: anxiety/nervousness, headache, insomnia, mood swings, sexual difficulties, nausea and stomach distress

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