7 remedies for fibromyalgia – Tua Saúde

Medicines for treating fibromyalgia are usually antidepressants, such as amitriptyline or duloxetine, muscle relaxants, such as cyclobenzaprine, and neuromodulators, such as gabapentin, for example, prescribed by the doctor. Additionally, alternative therapies, such as aromatherapy, psychotherapy or acupuncture, can assist in treatment and help control symptoms. Physiotherapy through exercises and massages is also important to help alleviate pain and prevent new attacks.

Fibromyalgia treatment is individualized and based exclusively on symptoms, so it is important to consult a rheumatologist, neurologist or psychiatrist to evaluate, diagnose and recommend the best treatment. Discover 4 physiotherapy treatments for fibromyalgia.

1. Antidepressants

Antidepressants are indicated for the treatment of fibromyalgia as they act directly on the brain, regulating substances important for its functioning such as serotonin, norepinephrine and dopamine and, thus, improve pain, fatigue and sleep and increase mood. The antidepressants most prescribed by doctors are:

• Amitriptyline (Tryptanol or Amytril): the recommended initial dose is 10 mg per day and should be taken at night, 2 to 3 hours before going to bed;
• Nortriptilina (Pamelor or generic): like amitriptyline, the recommended initial dose is 10 mg per day and can be gradually increased by the doctor, if necessary. The capsule must be taken at night before going to bed;
• Duloxetine (Cymbalta or Velija): generally, the initial dose is 30 mg and can be increased to a maximum of 60 mg per day according to medical assessment;
• Fluoxetine (Prozac or Daforin): for best effect, fluoxetine must be used in high doses, above 40 mg per day, however only the doctor can assess the dosage to be indicated;
• Moclobemida (Aurorix or generic): the recommended starting dose is 300 mg per day, generally divided into two doses and should be taken after meals. If necessary, the dose can be increased by a maximum of 600 mg per day.

The dose of all antidepressants is individualized and treatment must continue for at least 4 to 6 weeks to achieve the effectiveness of the medication.

2. Muscle relaxant

Muscle relaxants are used in fibromyalgia to reduce the stiffness of muscles that become stiff, causing pain throughout the body, in addition to improving sleep. In this case, cyclobenzaprine is the muscle relaxant recommended by the doctor and the recommended doses are 1 to 4 mg at night and the duration of treatment should be 2 to 3 weeks.

3. Antiparkinsoniano

Antiparkinsonians, which are medications for the treatment of Parkinson's, such as pramipexole (Stabil or Quera), are also indicated to reduce fibromyalgia pain and improve sleep. The recommended initial dose is 0.375 mg per day, and the dose can be gradually increased to a maximum of 1.50 mg per day.

4. Painkillers

Simple pain relievers like acetaminophen (Tylenol or generic) and opioids like tramadol (Tramal or Novotram) are recommended to improve fibromyalgia pain. These analgesics can be taken alone or can be combined for better pain relief, as they act on different stages involved in pain. The doses of these medications must be advised by your doctor and tramadol is only sold with a prescription.

5. Neuromoduladores

Neuromodulators act directly on the nervous system, regulating the pathways responsible for pain and, thus, effectively reduce the pain caused by fibromyalgia. These medicines include:

• Gabapentin (Neurontin or Gabaneurin): must be taken orally, at an initial dose of 300 mg per day, which can be increased to a maximum of 900 mg to 3600 mg per day;
• Pregabalin (Lyrica or Insit): the initial dose of 75 mg orally, twice a day, that is, 150 mg per day. The dose of pregabalin can be increased gradually, according to the doctor's assessment, up to a maximum of 450 mg per day, divided into 2 doses.

Both Gabapentin and Pregabalin can be taken before or after meals and are only sold with a prescription. It is recommended that the first dose be taken at night, at bedtime.

6. Sleep inducers

Sleep disorders are common in fibromyalgia, both insomnia and not getting restful sleep. Generally, sleep inducers are recommended to alleviate this type of disorder and include:

• Zopiclona (Imovane): the recommended dose is a maximum of 1 tablet of 7.5 mg orally at night and treatment should not exceed 4 weeks to avoid causing dependence;
• Zolpidem (Stilnox or Zylinox): a maximum of 1 tablet of 10 mg should be taken orally immediately before bed, as it takes effect 30 minutes after taking the dose, and the duration of treatment should be as short as possible, not exceeding 4 weeks .

Sleep inducers help reduce muscle tension caused by not sleeping well and are often recommended to complement the treatment of fibromyalgia pain.

7. Anxiolytics

Anxiolytics are medications that act to reduce anxiety, cause muscle relaxation and induce sleep, improving the symptoms of fibromyalgia. Anxiolytics should be used for a short period due to their ability to cause dependence and include:

• Lorazepam (Lorax or Ansirax): has an intermediate effect time of 10 to 20 hours and must be taken in a single daily dose of 1 to 2 mg, usually at bedtime;
• Diazepam (Valium or Uni-Diazepax): the duration of the effect of diazepam is longer, for 44 to 48 hours, and the recommended dose is 1 tablet of 5 to 10 mg orally, at night, which can be adjusted accordingly with medical evaluation.

Treatment with anxiolytics should always start with the lowest dose possible and last a maximum of 2 to 3 months.

In addition to medicines purchased at a pharmacy, some homemade remedy options such as teas and juices help to relieve fibromyalgia pain and reduce some symptoms such as tiredness and sleep disturbances. Learn more about home remedies for treating fibromyalgia.