DOCTOR'S VIEW ARCHIVE
NEWTON, MASS.-- Fibromyalgia (also known as fibrositis) is a chronic condition causing pain, stiffness, and tenderness of the muscles, tendons, and joints. Fibromyalgia is also characterized by restless sleep, awakening feeling tired, fatigue, anxiety, depression, and disturbances in bowel function.
While fibromyalgia is one of the most common diseases affecting the muscles, its cause is currently unknown. The painful tissues involved are not accompanied by tissue inflammation. Fibromyalgia affects predominantly women (90 percent) between the ages of 35 and 55. In the United States, over 3 percent of the population have fibromyalgia.
Since the symptoms of fibromyalgia are diverse and vary among patients, treatment programs have to be individualized. Treatment programs are most effective when they combine patient education, stress reduction, regular exercise, and medications.
Tricyclic "antidepressant" drugs have been used frequently to treat fibromyalgia. Amitriptyline (ELAVIL) is one of the most commonly used tricyclic drugs for fibromyalgia therapy. Fluoxetine (PROZAC) represents an entirely different class of antidepressant medications called serotonin reuptake inhibitors. There have been recent reports of success using fluoxetine to treat fibromyalgia
The results of a study by Don Goldenberg, M.D. and associates published in Arthritis & Rheumatism (1996;Vol.39,1852-9) suggest that combining amitriptyline and fluoxetine in the treatment of fibromyalgia can be even more effective than either drug alone.
Because the exact cause of fibromyalgia remains a
mystery we have yet to define an ideal treatment method for all
patients with this illness. The study by Dr. Goldenberg and associates
will open up many new avenues of options for future research looking
into the cause and treatment of fibromyalgia. Moreover, the
of medications useful in fibromyalgia may be more helpful to some
patients than continually searching for individual drugs for benefits
while risking side effect exposure.
For more information, please read the Fibromyalgia, Elavil, and Prozac articles.