Fibromyalgia is one of the most poorly-understood medical conditions. Those with the condition often experience near-constant pain, mental fog, depression, and anxiety, and fibromyalgia often develops over time.
Because this is a condition that is still being researched, doctors aren’t completely sure what causes it. However, according to the Mayo Clinic, there are several possible causes of fibromyalgia. These causes include physical or emotional trauma, genetics, and widespread infections.
With symptoms influencing nearly every area of a patient’s life, it’s clear that fibromyalgia is a condition that needs to be medically managed in order to ensure that patients have the best possible quality of life.
You may have read or heard about antidepressant therapy being used for this condition. While several classes of drugs have been used in treatment, some types of antidepressants show promise in treating this often difficult to understand the medical issue.
Here, we’ll investigate whether or not this type of therapy is likely to be beneficial for fibromyalgia treatment.
Fibromyalgia: A Closer Look
Fibromyalgia is a condition that is often misdiagnosed. Rheumatologist Dr.Robin Dore outlines the symptoms of fibromyalgia in this YouTube video.
Dr. Dore explains that, while fibromyalgia is a condition of widespread body pain, it is characterized by 18 tender points throughout the body.
She also says that, in many cases, fibromyalgia patients are hypersensitive to pain, light, sound, taste, touch, and smell. This may suggest that fibromyalgia is caused in part by a chemical imbalance that increases pain sensitivity.
As noted above, this chronic condition is characterized by a range of symptoms. According to WebMD, some of the most common fibromyalgia symptoms are as follows:
- pain all over the body
- anxiety and depression
- irritable bowel syndrome
- tingling or numbness in limbs
- “fibro fog,” which refers to a difficulty with concentration
Notably, fibromyalgia affects more women than men. While nobody knows for a fact why this is, it’s generally believed that hormonal responses to stress may be at least partially to blame.
According to ProHealth, hormonal levels affect gene expression, and women, on average, have higher hormonal activity when under stress.
If genetics play a factor in the development of this condition, it’s possible that women’s hormonal responses to stress make it more likely that fibromyalgia will develop.
What About Causes?
There are many possible causes of fibromyalgia, and for many patients, the condition develops due to multiple causes.
According to the NHS, one popular theory holds that, due to an imbalance of chemicals in the brain (and specifically, due to low levels of serotonin, norepinephrine, and dopamine), fibromyalgia patients have a heightened pain response.
As explained above, fibromyalgia may also be triggered by a stressful event, an injury, or chronic stress. Stressful events might include giving birth, loss of a loved one, or even childhood trauma.
Some research indicates that genetics may also help to determine whether or not someone will develop fibromyalgia. This includes being genetically predisposed to fibromyalgia, as well as changes in gene expression that make it likely to develop.
Because the possible causes of fibromyalgia are so diverse, this is a very difficult condition to treat.
However, in many cases, a surprising class of drugs has seemed to help. In the next section, we’ll look at how antidepressants may help patients cope with fibromyalgia symptoms.
Are Antidepressants Helpful?
Fibromyalgia patients over the past decades have been treated with a variety of prescriptions, including pain medication and anti-seizure medication.
However, according to NCBI, while tricyclic antidepressants were never officially approved for use in treating fibromyalgia, some doctors found that their patients’ symptoms improved while they were taking these antidepressants.
Unfortunately, tricyclic antidepressants often come with a long list of side effects, and for many patients, the drugs became difficult to take. Therefore, it became necessary to find a therapy option that would work long-term for more patients.
Doctors then tried one of the most commonly-prescribed types of antidepressants: SSRIs, or selective serotonin reuptake inhibitors.
In most cases, SSRIs had little effect on fibromyalgia symptoms. But when serotonin and norepinephrine reuptake inhibitors, or SNRIs, were tested in placebo-controlled trials, most patients experienced symptom relief.
And while SNRIs do have some side effects, they tend to not be as extreme as those of tricyclic antidepressants.
When you consider the theory that fibromyalgia may be caused, at least in part, by an imbalance of neurotransmitters, treating patients with SNRIs makes sense.
Because serotonin and norepinephrine help to regulate sleep, mood, and pain perception, it’s likely that they will help at least some patients experience relief from the debilitating effects of fibromyalgia.
However, some physicians argue that, while SNRIs may help with some aspects of the condition, they don’t treat it fully.
According to Medscape, a newer analysis of placebo-controlled studies found that patients on two of the most commonly-prescribed
SNRIs for fibromyalgia only experienced slight relief from symptoms.
Essentially, while it’s encouraging that there is a prescription that may help patients lead better lives, there is still much that needs to be done in terms of fibromyalgia research and treatment.
But for some patients, and especially those who experience severe depressive symptoms along with fibromyalgia, SNRI treatment may be helpful.
How Do You Know if Antidepressant Therapy is Right for You?
If you have been diagnosed with fibromyalgia, you might find much of what you read to be discouraging.
When even top doctors have described fibromyalgia as difficult to treat, and most articles about the condition refer to it as “poorly understood,” you might feel as though you’re going to be stuck with chronic, debilitating pain for the rest of your life.
However, effective management of fibromyalgia starts with a conversation with your doctor.
Since the condition often looks different in different patients, having a doctor who is familiar with your symptoms is a good place to start.
Together, you and your doctor can decide whether treatment with antidepressants is the best route for your treatment.