Have you ever had so much chronic pain in your muscles that you feel depressed? This is one way to describe fibromyalgia, but it is not as gentle as you might think. We will get into it shortly.
In the past decade, we have seen very many medications that have been screened to treat fibromyalgia. Some of the medications include corticosteroids, relaxants, sedatives, NSAIDs ( Non-steroidal anti-inflammatory medications), and tricyclic antidepressants.
There is some history in the use of tricyclic antidepressants to treat fibromyalgia. It is not a surprise that some antidepressants like amitriptyline, doxepin, and nortriptyline are given to patients who have fibromyalgia. Although amitriptyline is the most popular drug to treat fibromyalgia. But what is fibromyalgia?
What is fibromyalgia?
Fibromyalgia is a chronic disease that causes extensive musculoskeletal pain. We still don’t know what causes fibromyalgia, but some of the symptoms include:
- Painful tender joints
- Twitching and muscle pain or tightness
Even though there is no known cure, a combination of medication and therapies like stress management, exercise, healthy living habits, and medication can ease off the symptoms of an active life.
What is amitriptyline?
Amitriptyline which is also known as Elavil is a TCA drug used to treat depression symptoms. It can also be used in the treatment of chronic neuropathic pain and fibromyalgia.
Amitriptyline is used to increase the natural substance that controls the brain’s mental balance. It is also the most popular TCA drug that is frequently prescribed for patients suffering from fibromyalgia.
Fibromyalgia and Antidepressants
The most common fibromyalgia medications that are used to treat the symptoms include sleeping pills, antidepressants, and painkillers.
Since antidepressants are the most common fibromyalgia medications, they have been used for years by many patients. The category of antidepressants we are talking about is tricyclic antidepressants (TCA).
According to Boostmood, TCA medications have been used over the years to boost levels of neurotransmitters and brain chemicals. When there is a boost in the level of neurotransmitters, the brain is prevented from getting any impairment in its natural function.
Neurochemicals like norepinephrine and serotonin are boosted by these antidepressants. People who have chronic pain usually feel better after taking these antidepressants.
TCA is also an important player in relieving pain from the muscles. The body’s natural painkillers, known as endorphins are also boosted by TCA.
Although there are positive results with medications on fibromyalgia, the side effects that come along with these medications can make it tough for anyone to stick to the drug regularly.
Some of the TCA medications that are prescribed for fibromyalgia include milnacipran, duloxetine, and venlafaxine. According to the FDA, milnacipran and duloxetine are approved as medications for fibromyalgia.
On the other hand, venlafaxine has not been well researched to be recommended as the proper medication. Other antidepressants have been recommended as medications for fibromyalgia, they include:
Is Amitriptyline a good drug for fibromyalgia?
According to Dr. Andrew Moore of the University of Oxford and his associates, they concluded through research that TCA drugs have a much stronger effect on fibromyalgia, compared to placebo drugs. Controlled studies have been done, and the results have shown that amitriptyline improves stage 3&4 sleep disorders.
Additionally, the studies have highlighted that people suffering from fibromyalgia experience pain relief after using Amitriptyline.
The study that was taken comprised of 70 fibromyalgia patients, who were provided with 50 mg of Amitriptyline. These patients showed a considerable change in their quality of sleep after a few days.
These patients woke up without morning stiffness, experienced less pain and they had a general improvement in how they felt throughout their bodies. Although the improvements were several, the tender point score did not change.
After Amitriptyline was taken, it had some side effects to the patients which included:
- Urinary retention
- Morning sedation
- Dry mouth
After the study was done, it was concluded that the medication needs to be personalized, so that change can be experienced at the maximum level after understanding someone’s physical capacity and extent of the condition.
Dosage of Amitriptyline
When the drug is administered one or two hours before bedtime, you can minimize feelings of hangover or morning sedation. If a response is not noted, then an increase of the dose can be done after two weeks.
Seven random trials were tested on the efficacy of amitriptyline as a fibromyalgia treatment. It was discovered through the study that 25 mg of amitriptyline a day in six trials resulted in a therapeutic response, compared with a placebo drug that didn’t have that much of an effect, after being inducted in the domain of sleep, pain, and fatigue.
After six to eight weeks, the treatment seemed to benefit the patient, but after twelve weeks, there was no effect at all. After 50 mg of amitriptyline prescription, a day trial test in four random people was made, but there was no therapeutic effect witnessed.
After the trials, there was no effect of neither 25 mg or 50 mg of amitriptyline on tender joints.
In conclusion, for short-term treatment, there was some evidence that supported the efficacy of 25mg of amitriptyline, while no evidence came out to support higher doses of amitriptyline for periods longer than eight weeks.
Disclaimer before amitriptyline dosage
Before taking any dosage of amitriptyline, you need to understand your medical history first, to avoid any complications. If you are struggling with fibromyalgia, you should consult your doctor before taking amitriptyline medication.
Some of the conditions that might bring issues with the medication include:
- Pregnant women
- Heart disease
- Prostate problems
- An overactive thyroid gland
Amitriptyline side effects
Before taking any amitriptyline medications, you should be aware of their side effects.
Just like most drugs, amitriptyline causes some side effects that may not be exhibited on every patient. Some of these effects include:
- A headache
- Low blood pressure
- Blurry vision
- Increase in hunger
- Dry mouth
- Challenges in urinating
Below is a list of some techniques you can use to limit some of these side effects.
- When you start feeling dizzy, sit down and let the feeling pass.
- You can control some of the side effects when you wake up slowly in the morning.
- Avoid alcoholic drinks.
- Don’t use machines or tools when you are experiencing the side effects.
- Eat a balanced diet that has lots of fiber to help relieve constipation.
- Suckle on sugar-free sweets or Chewing gum to counter dry mouths.
How to take amitriptyline
When you are taking any kind of drug, you have to understand the drug, how to use it, and when to take it. Reading the instruction provided in the leaflet will help you to know what to avoid when taking the drug.
Generally, your doctor will advise you on how to take the drug. Most often, the drug is prescribed as a single daily dose that is taken before bedtime, but prescriptions vary for every patient.
Learn everything you can on amitriptyline, and in case of any queries, consult your doctor.
It is also common for a doctor to prescribe a small dose at first, and then gradually increase the dosage with time. Remember to take your dose on time, but do not take two doses to recover for the last one you missed.
Remember to keep track of your medication and don’t miss out on any doctor appointment for your progress to be monitored.
Benefits of amitriptyline, exercise, and more
In a 2012 study, it was suggested that amitriptyline should be placed as a treatment of fibromyalgia or neuropathic pain, even though very few people stated that they had satisfactory pain relief after using the drug.
But can exercise and amitriptyline help in the alleviation of fibromyalgia symptoms?
According to Healthline, it is possible to use a no-medical approach to treat fibromyalgia. Some of the approaches that can work include the uptake of strength training and aerobic exercises.
When you combine the proper use of amitriptyline with proper exercise routines, you can easily decrease the symptoms, have better-sleeping patterns, reduce the pain felt in joints and also reduce fatigue.
Below is a video that shows some home exercises that you can do to help you recover from fibromyalgia.
One such exercise that demonstrates a high relief effect in the long-term is aquatic exercises. The most appealing aspect of this exercise is the fact that it combines resistance swimming, cardio exercises, water aerobics, swimming, and other aquatic-based exercise programs that are effective for fibromyalgia patients.
Since patients who suffer from fibromyalgia are affected by cold temperatures, they need to swim in warm water pools in environments that are controlled.
The therapy programs we have looked at suggest that fibromyalgia patients can benefit heavily, even though they will have to work through the pain.
Therapy for fibromyalgia patients
Art therapy, counseling, and music therapy can work wonders with kids. But for adults, they have not been enough studies to indicate any significant effect.
In adults, Cognitive Behavioral Therapy and other psychological therapies, accompanied by amitriptyline are the preferred treatment according to Don L Goldenberg, MD. To provide comfort, patients experience a lot of pain alleviation after guided imagery and deep-breathing exercises.
When you combine the positive effects of exercise, amitriptyline, and therapy, you can improve pain management and the lifestyle of a patient. It is important to note that you need to consult your doctor regularly to ensure that you manage your condition well.