Answer: There are a multitude of drugs used to treat FM. This page will have a whole section devoted to medications. I am, as you might imagine, somewhat opinionated (as most physicians are) as to what works and what doesn't work. What I emphasize to my patients, however, is I specifically data track patients and utilize sophisticated means to determine what works and what doesn't work. I have my opinions, these are supported. Keep watching this page.

NOTE: The delay in putting up more specific information on this topic is that it must be first and foremost accurate, but also within certain guidelines that I think would fall under scrutiny of the FDA (Food & Drug Administration). I'm going to put in my clinical experiences, but these are not going to be posted unless I'm clear that it is accurate, informative and responsible. Don't expect to see a lot of junk science. For example, glucosomine and chondroitin sulfate, in my opinion, are supported by junk science. They are nothing more than placebo effect in reality. If they help some people, fine, keep taking it. I can't find any reproducible results in my practice. This is the type of thing I'm going to be looking for.

Answer: Amitryptilline is fine. Naproxen is probably useless. Naproxen can lead to problems with GI (gastrointestinal) bleeding that I think could be risk vs. benefit ratio away from fibromyalgia. The good news about Naproxen is that many patients that suffer from FM through a process of deconditioning, etc. tend to have some spinal axial disease. Naproxen may help this. From your e-mail, it doesn't sound like you have any of this, so it's best to leave out the NSAIDS.

Amitryptilline has been shown to be helpful. I think it's an OK drug, but the problem with Amitryptilline is that people gain weight. This is not something that most FM patients need.

Answer: I seriously doubt that fibromyalgia is caused by a microplasmic organism. I'm not saying it's impossible but I need to see more evidence. Not everyone who has an infection has fibromyalgia and vice versa. Antibiotics as a treatment for fibromyalgia -- Don't do it. There's poor and dismal proof that antibiotics are useful in the treatment of fibromyalgia.

For example: a patient develops a systemic infection. Multiple organisms can cause this systemic infection. Does this patient exhibit symptoms of fibromyalgia? Does this patient evolve to develop fibromyalgia? If this were an epidemiological problem, it would have been identified many years ago. Another example, we now know that [helicobacter] causes stomach ulcers. Stomach ulcers hurt. Do the sufferers develop long-term, organic stomach pain simply because they have an infection in their stomach? The answer is "no". Long-term antibiotic treatment is also fashionable with Interstitial Cystitis patients. They believe that an organism is causing most of their problems. This is usually restricted to reside in the bladder. In fact, it's probably either an opportunistic infection or else a secondary infection that may be a result but not certainly the cause.

Long-term antibiotic exposure is fraught with potentially damaging and even devastating results. Not only is certain yeast allowed to overgrow, but resistance can develop. This is not as benign a problem as it sounds. The colon can be sterilized leading to something called pseudo membranous colitis, which has even been fatal. Antibiotics are not to be played with. They are a specific tool used to create a specific diagnosis. As always with fibromyalgia and the Fibro 5, diagnosis, diagnosis, diagnosis. Supported specific treatment. Watch out for anecdote and useless assumption.

Answer: No. Just as not all depressed people get fibromyalgia, not all fibromyalgia sufferers get depression. A researcher measured [serotonin] in the central nervous system and found that it was decreased. Fibromyalgia patients were then assumed to be depressed and have interrupted sleep patterns secondary to this biochemical event. Personally, I don't see the cause and effect. Other data has revealed that antidepressants really don't improve outcome in most fibromyalgia patients, just symptoms.

The upside of antidepressant therapy and some psychosocial therapy is that it just plain makes people feel better. Does it improve function? I'm not sure. I've started to look into this.

Answer: Actually, there are some medications that some rheumatologists and others that treat fibromyalgia use. One is Cylert. Some practitioners have used Ritalin, etc. I don't know of any outcome studies that support use of any of these. I'll look into this a little further. Talk it over with your rheumatologist or pain doctor.

About every study that links fibromyalgia with exercise does state that increasing cardiovascular activity helps with energy levels. This is tough for most fibromyalgia patients, as they don't feel they can get up and move around secondary to their pain and fatigue.