Treating Fibromyalgia

Question:

I am taking cymbalta, concerta and ambien – this week to substitute daytrana – for fibromyalgia. Key problems are sleep, pain, mental fog, low energy to the level of cfs. Is it standard treatment to use a stimulant drug for this condition? I have relief in all areas when taking the meds – but the energy and motivation are still laggin behind. (this question originally appeared as a comment on the article Determining the Best Stimulants.)

— Linda

Answer:

Strictly speaking, there is no standard treatment for Fibromyalgia. I’m not aware of any treatment having formal FDA approval. Cymbalta does have some positive controlled studies and Eli Lilly may be applying for approval.

Low thyroid is a common problem associated with fibromyalgia (see Thyroid Facts and Myths).

Stimulants are frequently used for chronic fatigue although they are not FDA approved for this. You are on a good combination of meds. If you are taking Cymbalta early in the day, switching to bedtime might help.

There are multiple options that could help motivation and energy levels:

  • Increasing Concerta
  • Increasing Cymbalta
  • Adding Wellbutrin XL

Of course, you would need to discuss options with your doctor. It’s usually best to make only one change at a time.

Good luck!

Dr. Jones

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