New Fibromyalgia Treatment: A Breach In Pain

The first step in fibromyalgia treatment is to fix the sleep disturbance or problem of the patient with the use of tricyclics.  Amitriptyline (10–50 mg), nortriptyline (10–75 mg), and doxepin (10–25 mg) are the commonly used tricyclics. A similar drug based on pharmacology, cyclobenzaprine (10–40 mg), taken one to two hours before bedtime will put the patient’s sleep at stage 4, resulting in clinical improvements. Patients are given these drugs at a minimum dose but if needed, dose given is increased slowly. Patients should be informed of these drug’s side effects such as stomach and intestinal problems, dry mouth, gaining weight, sleepiness, and difficulty in thinking. Trazodone is also given, as well as zolpidem, as these improve the quality of sleep.

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