Living with fibromyalgia can be a pain, both literally and figuratively. This is especially true if you’re struggling to find treatments that help with the pain and fatigue. While fibromyalgia can’t be cured, treatment options can make the condition easier to manage.

In this article, we’ll talk about some of the latest treatments for fibromyalgia. We’ll review some of the medications commonly used to manage fibromyalgia symptoms, including antidepressants and anti-seizure medications. We’ll also cover how psychotherapy, lifestyle changes, and other treatments can help improve fibromyalgia symptoms.

Medications for Fibromyalgia

There are currently only three drugs specifically approved by the U.S. Food and Drug Administration (FDA) to treat fibromyalgia. However, many other drugs are prescribed off-label for fibromyalgia. This means that while the medication isn’t specifically approved to treat fibromyalgia, doctors often prescribe it because it may help with fibromyalgia symptoms.

Fibromyalgia medications fall into three main categories: antidepressants, anti-seizure medications, and pain medications. In addition to these, other types of medications may be used to help treat specific symptoms of fibromyalgia.

Antidepressants

Some antidepressants have been proven to help ease chronic pain, especially nerve pain. Of course, antidepressants can also help treat depression, another common symptom of fibromyalgia.

All antidepressants work by changing the balance of neurotransmitters — chemicals that transmit nerve signals — in the brain. Each class of antidepressants works in a slightly different way. Common side effects of most antidepressants include drowsiness and sexual dysfunction, especially for the first few weeks or months.

SNRI Antidepressants

Two of the FDA-approved drugs for fibromyalgia belong to the norepinephrine and serotonin reuptake inhibitor (SNRI) class of antidepressants. These medications are duloxetine (Cymbalta) and milnacipran (Savella). Doctors often use these medications as the first treatment for fibromyalgia in people with severe fatigue (extreme tiredness or lack of energy) or depression.

Tricyclic Antidepressants

Other antidepressants are frequently prescribed off-label to treat fibromyalgia symptoms. Before the FDA had approved any medications for fibromyalgia, researchers discovered that tricyclic antidepressants could help manage symptoms. Doctors continue using tricyclic antidepressants off-label as one of the first treatments for people with fibromyalgia. One commonly used tricyclic antidepressant is amitriptyline.

SSRI Antidepressants

Sometimes doctors recommend another type of antidepressant called selective serotonin reuptake inhibitors (SSRIs). These medications are usually prescribed for people who can’t take other recommended fibromyalgia medications or for whom other medications did not work. However, research is not as clear about how well these medications work for fibromyalgia. Examples of SSRI medications include fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft).

Anti-Seizure Medications

Although seizures are not a common symptom of fibromyalgia, some anti-seizure medications (also called anticonvulsants or antiepileptic drugs) can be effective in treating fibromyalgia. Anti-seizure drugs are believed to help by calming overactive nerves and reducing the transmission of pain signals. Common side effects of anticonvulsants include drowsiness and mood changes, such as depression.

The final FDA-approved drug for fibromyalgia is an anti-seizure medication called pregabalin (Lyrica). Research shows that pregabalin helps reduce pain and improve sleep and quality of life for people with fibromyalgia. Besides being used to treat fibromyalgia, pregabalin can be used for neuropathic pain and generalized anxiety disorder. Pregabalin is also prescribed off-label to treat restless legs syndrome, a disorder common in people with fibromyalgia.

Other antiepilepsy drugs may also be prescribed off-label to treat fibromyalgia. One example is gabapentin (Neurontin).

Pain Management Medications

Pain is the most common symptom of fibromyalgia, and it can be severe. Medications for fibromyalgia pain management include over-the-counter pain relievers and prescription medications. Several of the medications described above can help with fibromyalgia pain.

Opioids are no longer recommended for fibromyalgia because of the risks associated with them. According to the National Institute on Drug Abuse, regular use of opioids — even as prescribed by a doctor — can lead to dependence. If misused, opioids can result in overdose and death.

Some people with fibromyalgia find relief from pain and improved sleep by using medical cannabis (medical marijuana). However, cannabis is not usually effective for people with more severe fibromyalgia symptoms.

Other Medications

Other medications can also be used to manage specific symptoms of fibromyalgia. Muscle relaxants, such as carisoprodol (Soma) and orphenadrine, can improve stiffness in some people with fibromyalgia. However, these medications should only be used for a short time and not on a regular basis.

Fibromyalgia often causes problems with sleep, and certain medications can help with this. These include prescription sleeping pills and supplements of melatonin, a natural sleep hormone. Sometimes benzodiazepines like lorazepam (Ativan), diazepam (Valium), and alprazolam (Xanax) can also be used to help with sleep problems, although these drugs are more often prescribed to treat anxiety. Anxiety is a common trigger for fibromyalgia pain.

Finally, medications called stimulants can help with fatigue and cognitive dysfunction (difficulty thinking) related to fibromyalgia. These stimulants include modafinil (Provigil) and amphetamine/dextroamphetamine (Adderall).

Psychotherapy

In addition to medication, doctors recommend people with fibromyalgia undergo psychotherapy to help with managing their disease. Physical and psychological pain can be closely linked. There is a correlation between a history of depression, anxiety, or post-traumatic stress disorder (PTSD) and the development of fibromyalgia.

Psychotherapy can help people with fibromyalgia work through traumatic memories and find healthy ways to cope with stress. In particular, cognitive behavioral therapy, mindfulness-based stress reduction, and relaxation can be helpful. These therapies can help change thoughts and behaviors that directly contribute to physical symptoms such as pain.

Lifestyle Changes

Making positive lifestyle changes can greatly improve the lives of people living with fibromyalgia. In fact, doctors highly recommend exercise as one of the initial treatments for fibromyalgia.

Exercise

Exercise can be difficult for people with fibromyalgia. Pain, stiffness, and fatigue lead many people with fibromyalgia to give up on exercise. However, a lack of physical activity can increase pain and stiffness, which can make fibromyalgia symptoms worse. Not getting regular exercise also increases the risk of other serious medical conditions like osteoporosis (brittle bones), heart disease, and diabetes. Research has shown that regular exercise helps people with fibromyalgia maintain a healthy weight, keep joints flexible, and reduce inflammation and stress.

When starting a new exercise routine, you may feel more pain at first. The best way to deal with this is to start with short, low-intensity exercises, then increase the duration and intensity when you can handle it. For fibromyalgia, aerobic exercise is specifically recommended. Your doctor or physical therapist can help determine which exercises are right for you.

Diet

There is no specific diet that helps everyone with fibromyalgia. Like everyone else, people with fibromyalgia feel better when they eat a balanced diet with plenty of fresh fruit, vegetables, and unsaturated fats. Reaching and maintaining a healthy weight is extremely important for people with fibromyalgia. Studies have shown that having a higher body weight is associated with worse fibromyalgia symptoms. Eating a nutritious, balanced diet can make a significant difference in managing fibromyalgia.

While there are no diets specifically for fibromyalgia, some people with fibromyalgia can benefit from changing their diet. For example, researchers have found that nutrient deficiencies are common in people with fibromyalgia. A blood test can find deficiencies, and a doctor can provide advice on which foods and supplements will help.

Other studies have found an overlap between fibromyalgia and gluten intolerance. Some people with fibromyalgia feel better when they remove gluten from their diets. Others report reduced symptoms after changing to an anti-inflammatory diet. Eating a plant-based diet may also help improve symptoms. It is important to check with your doctor before making dietary changes, since some trendy diets and supplements can interfere with medication or cause unwanted side effects.

Stress Management

Stress is a common trigger for fibromyalgia flares, and reducing stress may have benefits for people with fibromyalgia. Some ways to manage stress include deep breathing, meditation, prayer, yoga, or tai chi. Connecting with family and friends, undergoing psychotherapy, and taking antidepressant medication (if prescribed) can also help with stress relief. Talk to your doctor if you have concerns about managing your stress.

Natural or Complementary Treatments

Some people with fibromyalgia feel better after trying various complementary or alternative therapies. Trigger point injections and massage therapy can help manage pain.

Some research studies have suggested a benefit from acupuncture, biofeedback therapy, chiropractic therapy, or peripheral nerve stimulation. However, these studies showed mixed results or were not well designed. More research is needed to see if these therapies can help with fibromyalgia.

Talk With Others Who Understand

On MyFibroTeam, the social network for people with fibromyalgia and their loved ones, more than 289,000 members come together to ask questions, give advice, and share their stories with others who understand life with fibromyalgia.

Have you used any of these treatments to manage your fibromyalgia? Which treatments worked best for you? Share your experiences in the comments below, or start a conversation by posting on your Activities page.