What are Antidepressants?
Antidepressants are "associated with improvements in pain, depression, fatigue, sleep disturbances, and health-related quality of life in patients with FMS." Drugs that simultaneously increase the amount of two brain nerve transmitters, serotonin and norepinephrine; have been approved to treat fibromyalgia in adults. These drugs include duloxetine and milnacipran.
Most Common Types of Antidepressants
- Tricyclic Antidepressants (Elavil) - Serotonin-norepinephrine reuptake inhibitors. Elavil is a potent antihistaminic and anticholinergic medications. Elavil also inhibits sodium and calcium channel at cell membrane. The side effects secondary to antihistaminic action such as somnolence is beneficial in treating fibromyalgia. Tricyclic antidepressants appear to reduce fatigue, relieve muscle pain and spasm, and promote deep, restorative sleep in patients with fibromyalgia. Tricyclics work by interfering with a nerve transmitter chemical in the brain called serotonin. Tricyclic medications can cause tiredness and fatigue. Examples of tricyclic antidepressants commonly used in treating fibromyalgia include amitriptyline (Elavil) and doxepin (Sinequan).
- Prozac I - Prozac is selective serotonin reuptake inhibitor. Prozac does not inhibit norepinephrine or dopamine reuptake. Low dose with Elavil has been effective in symptomatic relief. The combination is also more effective in promoting restful sleep and improving an overall sense of well-being. Prozac can make patients more cheerful and awake. Useful in combination with Elavil. Prozac has also been shown to be effective when used alone for some patients with fibromyalgia
- Trazadone (Desyrel) - Serotonin antagonist and reuptake inhibitor. It is anxiolytic and hypnotic. It has least anticholinergic effects such as dry mouth, constipation, tachycardia and sexual side effects, which are common with Elavil. Trazadone can be taken at bedtime to improve sleep when tricyclic antidepressants are not tolerated.
- Duloxetine (Cymbalta) - Increases amount of serotonin and norepinephrine in brain by inhibiting the uptake. Therapeutic dosage is effective in treating depression and neuropathic pain. Cymbalta also suppresses anxiety in-patient with history of fibromyalgia and neuropathic pain.
- Milnacipran (Savella) - Similar to duloxetine inhibits reuptake of serotonin and norepinephrine.
Reporting the Side Effects of Antidepressants
Report side effects to Food and Drug Administration's (FDA.)
Contact Information: URL: www.fda.gov/safety/MedWatcher or Call 1-800-332-1088, 1-800-332-1088 (USA). 1-866-234-2345, 1-866-234-2345 (Canada).
- Inform your doctor immediately.
- Go to nearest ER immediately if you cannot get hold of your doctor.
- See list of side effects under description of each medications.
- If side effects remain consistent until next dose or intolerable contact your physician or go to ER.
- Signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Prescription Instructions for Antidepressants
- Read the directions carefully.
- If you do not understand any part of instruction discuss with your doctor or pharmacist.
- Follow the instructions carefully. Take the pills or liquid as prescribed. Do not increase or decrease frequency or quantity on your own judgment; you will be exposed to side effects or withdrawal symptoms.
Overdose of Antidepressants
- Call 911, immediate resuscitation is most important initial step in treating life-threatening symptoms.
- Call poison center 1-800 222 1222. Call after initial treatment is resume.
Sharing Antidepressant Medications
Do not share medications with your friend or relatives. Each individual has different history of allergies, drug interaction, drug shopping, addiction and other general health concern. Physician must prescribe medications after detail history and examination. Small error may be life threatening.