Experts do not know exactly how SSRIs
work to improve
fibromyalgia. But some people with fibromyalgia who
take SSRIs seem to have improved mood and less fatigue.
medicines are a type of antidepressant. Doctors also prescribe them to treat
Doctors may prescribe SSRIs when
mood problems are a major symptom of fibromyalgia.
SSRIs seem to improve mood and may
help relieve pain, fatigue and sleep problems.1 Some
people taking fluoxetine report decreased pain and improved ability to
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
or other emergency services right away if you have:
Call your doctor if you have:
Common side effects of this medicine include:
FDA advisories. The U.S. Food and
Drug Administration (FDA) has issued:
See Drug Reference for a full list of side effects. (Drug
Reference is not available in all systems.)
Never suddenly stop taking antidepressants. The use of any
antidepressant should be tapered off slowly and only under the supervision of a
doctor. Abruptly stopping antidepressant medicine can cause negative side
effects or a relapse into a depressive episode.
People with liver
disease usually require lower doses of SSRIs.
Studies have found that daily use of SSRIs may increase
the risk of bone fracture in adults over age 50. Talk to your doctor about this
risk before taking an SSRI.3
bleeding more likely in the upper gastrointestinal tract (stomach and
esophagus). Taking SSRIs with NSAIDs (such as Aleve or Advil) makes bleeding
even more likely. Taking medicines that control acid in the stomach may
Sexual dysfunction can be a
significant problem for some people while taking an SSRI. A medicine such as
sildenafil (Viagra) may help both men
and women who have sexual problems caused by SSRIs.5, 6
Studies suggest that using a
selective serotonin reuptake inhibitor (SSRI) and a tricyclic antidepressant
(such as amitriptyline) together may be more successful at
breaking the cycle of pain and sleep problems caused by fibromyalgia than using
just a single medicine.
Treatment with antidepressants does not
always relieve symptoms caused by fibromyalgia. Even when the treatment does
work, some people may find the side effects of these medicines unacceptable.
The dose of an SSRI used to treat fibromyalgia is usually the same as that
needed to treat depression.
Using an antidepressant medicine to
treat fibromyalgia does not mean that the condition is "all in your
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
Women who take an SSRI during pregnancy have a slightly higher chance of having a baby with birth defects. If you are pregnant, you and your doctor must weigh the risks of taking an SSRI against the risks of not treating your panic disorder.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
Rao SR, Clauw DJ (2004). The management of
fibromyalgia. Drugs of Today, 40(6):
Bradley LA, Alarcon GS (2005). Fibromyalgia section of
Miscellaneous rheumatic diseases. In WJ Koopman, LW Moreland, eds.,
Arthritis and Allied Conditions: A Textbook of Rheumatology, 15th ed., vol. 2, pp. 1869–1910. Philadelphia: Lippincott
Williams and Wilkins.
Richards JB, et al. (2007). Effect of selective
serotonin reuptake inhibitors on the risk of fracture. Archives of Internal Medicine, 167(2): 188–194.
Abajo FJ, Garcia-Rodriguez LA (2008). Risk of upper
gastrointestinal tract bleeding associated with selective serotonin reuptake
inhibitors and venlafaxine therapy. Archives of General Psychiatry, 65(7): 795–803.
Nurnberg HG, et al. (2003). Treatment of
antidepressant-associated sexual dysfunction with sildenafil. JAMA, 289(1): 56–64.
Nurnberg GH, et al. (2008). Sildenafil treatment of
women with antidepressant-associated sexual dysfunction: A randomized
controlled trial. JAMA, 300(4): 395–404.
May 14, 2012
Anne C. Poinier, MD - Internal Medicine
& Karin M. Lindholm, DO - Neurology
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