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All About FibromyalgiaA Guide for Patients and their Families$
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Daniel J. Wallace and Janice Brock Wallace

Print publication date: 2002

Print ISBN-13: 9780195147537

Published to Oxford Scholarship Online: November 2020

DOI: 10.1093/oso/9780195147537.001.0001

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PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press, 2021. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use. date: 13 June 2021

Medicines that Work for Fibromyalgia

Medicines that Work for Fibromyalgia

21 Medicines that Work for Fibromyalgia
All About Fibromyalgia

Daniel J. Wallace

Janice Brock Wallace

Oxford University Press

Nobody likes to take medicine. Many fibromyalgia patients, in particular, prefer to treat their condition with natural remedies, and many are reluctant to take prescribed medication. This problem is made more difficult because many of the most helpful preparations are designated as antidepressants. Some patients become concerned that this might create a stigma. “If you really believe what I am saying, and are convinced that I am not crazy, why are you giving me an antidepressant or antianxiety drug?” is a question we frequently hear. This problem is compounded when some insurance companies refuse to reimburse patients for these preparations, claiming that they are uncovered “psychiatric benefits.” Management of fibromyalgia includes medications from separate families or groups, in which at least one agent has been shown in double-blinded, controlled trials (where some of the study subjects get placebo, or sugar pills) to be effective in fibromyalgia patients. The rationale for using these drugs in treating fibromyalgia is reviewed in this chapter, but first the scientific logic behind putting these drugs on our “A” list will be discussed. In the United States, the Food and Drug Administration (FDA) approves drugs for specific indications. It takes many years and many dollars for an agent to be approved for a specific use, and since fibromyalgia was not recognized as a disorder until 1990, no drugs currently have FDA approval for the condition. Many of the remedies purported to help fibromyalgia are beyond the FDA’s regulatory control. These include a variety of vitamins and agents that are licensed as food supplements. As a result, promising preparations such as DHEA and melatonin (reviewed in chapter 22) are widely available without a prescription and are being taken by patients even though few controlled trials have documented their safety or efficacy. For example, there is no legal obligation to prove that a 3-mg tablet of melatonin really contains 3 mg. Also, each batch of medication can be mixed with varying preservatives, which may affect its delivery, or bioavailability. Some of our patients have no difficulty taking the medication but react to its packaging. Physicians who manage fibromyalgia patients must rely on scientific studies showing that a drug is effective in alleviating a particular condition.

Keywords:   Aleve, Motrin, Naprelan, Orudis KT, acetic acid derivatives, benzodiazepine, depression, dizziness

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