Is gabapentin (Neurontin, others) an effective fibromyalgia treatment?
Answer
from Ann Vincent, M.D.
Only one high-quality clinical trial has looked at gabapentin (Neurontin, others) as a fibromyalgia treatment. In that study, the drug reduced participants' reported pain, fatigue and sleep disruption more effectively than did a placebo.
Gabapentin has not been approved by the Food and Drug Administration (FDA) for the treatment of fibromyalgia, although some doctors may prescribe it off-label for such use. The FDA has, however, approved a similar drug — pregabalin (Lyrica) — for fibromyalgia treatment.
Gabapentin and pregabalin were originally approved to treat certain types of epilepsy and nerve pain. Both drugs work by limiting the release of pain-communicating chemicals by nerve cells in the brain and spinal cord.
Because gabapentin is available in generic form, it may be less expensive than pregabalin. But you have to take gabapentin three or four times a day, which makes it less convenient than pregabalin, taken in two daily doses. The most common side effects of both drugs are dizziness and drowsiness.
Is fibromyalgia hereditary?
Answer
from Connie Luedtke, R.N.
Fibromyalgia isn't passed directly from parents to children the way diseases such as cystic fibrosis and hemophilia are. But family studies have found that the odds of having fibromyalgia are several times higher in the immediate families of people with fibromyalgia than in families in which no one has fibromyalgia. These observations suggest that heredity is a factor in causing fibromyalgia.
In fact, studies of DNA from family members of people with fibromyalgia and chronic pain syndromes have turned up a number of genes that could help explain why these disorders seem to run in families. Each of these genes plays a role in your nervous system's response to things that hurt, such as pressure and heat. Some of the same genes are also associated with depression and anxiety, which may be the reason why certain antidepressant medications help reduce fibromyalgia symptoms.
Researchers are now trying to connect differences in individuals' pain thresholds to particular variants of specific genes. A variant of the gene that determines how efficiently nerve cells recycle the neurotransmitter serotonin has already been correlated with heightened pain sensitivity.
I have fibromyalgia. Whenever my rheumatologist does blood tests, I'm told that I have elevated ESR and CRP levels. What's the significance of these test results?
Answer
from April Chang-Miller, M.D.
An elevated erythrocyte sedimentation rate (ESR) or a high level of C-reactive protein (CRP) in your blood may indicate inflammation somewhere in your body. However, it's not likely related to your fibromyalgia, since fibromyalgia isn't an inflammatory condition. Various conditions can cause elevated ESR and CRP levels, including:
- Infection
- Rheumatoid arthritis
- Inflammatory bowel disease
- Cardiovascular disease
- Cancer
To better understand the clinical significance of your elevated ESR and CRP levels, consult your doctor.
Hypnosis For Fibromyalgia
The symptoms of fibromyalgia can sometimes be so painful that they prevent sufferers from going to work, attending school classes, or just managing their daily routines. Unfortunately, there is no cure available for fibromyalgia syndrome, so patients often resort to numerous different treatments to lessen the severity of their fibromyalgia symptoms. However, hypnosis is now emerging as one of the best alternative treatments available for fibromyalgia pain. The use of hypnosis has been proven to reduce pain symptoms and it has become a doctor-recommended treatment. If you are suffering from fibromyalgia pain symptoms, consider hypnosis as a treatment option.
