Double Up These Two Drugs to Fight Fibromyalgia Pain

Double Up These Two Drugs to Fight Fibromyalgia Pain

By Staff

Is there a more effective way to treat fibromyalgia?

A Canadian researcher think he has uncovered one. Ian Gilron is the Director of Clinical Pain Research, Professor of Anesthesiology, and Biomedical Sciences, and Faculty in the Centre for Neuroscience Studies at Queen’s University in Kingston, Ontario, Canada

The results of a trial suggest that combining pregabalin (Lyrica), an anti-seizure drug, with duloxetine (Cymbalta), an antidepressant, can safely improve outcomes in fibromyalgia, including not only pain relief, but also physical function and overall quality of life. Until now, these drugs have been proven, individually, to treat fibromyalgia pain.

“Previous evidence supports added benefits with some drug combinations in fibromyalgia,” says, Dr. Gilron. “We are very excited to present the first evidence demonstrating superiority of a duloxetine-pregabalin combination over either drug alone.”

Fibromyalgia was initially thought to be a musculoskeletal disorder. Research now suggests it’s a disorder of the central nervous system – the brain and spinal cord. Researchers believe that fibromyalgia amplifies painful sensations by affecting the level and activity of brain chemicals responsible for processing pain signals.

“The condition affects about 1.5 to 5 per cent of Canadians – more than twice as many women as men. It can have a devastating on the lives of patients and their families,” explains Dr. Gilron. “Current treatments for fibromyalgia are either ineffective or intolerable for many patients.”

This study is the latest in a series of clinical trials – funded by the Canadian Institutes of Health Research (CIHR) – that Dr. Gilron and his colleagues have conducted on combination therapies for chronic pain conditions. By identifying and studying promising drug combinations, their research is showing how physicians can make the best use of current treatments available to patients.

“The value of such combination approaches is they typically involve drugs that have been extensively studied and are well known to health-care providers,” says Dr. Gilron.

This new research was published in the journal Pain.

Dr. Gilron and his research team at Queen’s are members of the SPOR Network on Chronic Pain. The national network, funded under Canada’s Strategy for Patient-Oriented Research, directs new research, trains researchers and clinicians, increases access to care for chronic pain sufferers, and speeds up the translation of the most recent research into practice.

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Authored by: Staff

There are 27 comments for this article
  1. Tracy at 8:05 pm

    I have recently come across a clinic in Arizona. Doctors have researched Fibro for years, you have to go there for treatment and they claim to have a 100% success rate. Google ENVITA there are videos, listen to what they have to say. I have suffered for 10 years now, and tried so many different things. Both prescribed and natural. Just some interesting information for the group.

  2. soha saba at 3:55 pm

    started with gabapentin, then pregabalin. ended with amitriptyline and Duloxetine plus Bupronorphine patches. Now stable on these for years. But no one is the same as other and every person metabolize and react to drugs differently. there is no point until trying in person

  3. Shirley Allen at 12:02 pm

    I was diagnosed with features had already taking gabapentin,because I was diagnosed with audio immune deficiency. And my eye sight mess up, swelling of hands and feet. It was used for seizure disorder…
    .

  4. Tina Chambers at 10:06 pm

    I took both but it seemed to me that the lyrica caused a reduction in the effectiveness of the cmybalta which does help me some. I quit the lyrica

  5. Chris Poff at 9:28 pm

    The combination of lyrica and cymbalta made me bedridden and I gained 65 lbs. my pain was much worse and i couldn’t recall words that i was trying to say. Made me feel dumb and caused neurocardiac syncope. I was passing out a lot so I weaned myself off these 2 drugs. I’ve lost the 65 lbs that i had gained. I will not take them again!

  6. Maria Rodriguez at 4:04 pm

    I couldn’t tolerate the side effects of Lyrica give me more pain that I had reached 280 pounds and then the doctor you told me I had to lose weight. The cymbalta would not let me sleep with nightmares the people around me get crazy with the screams at night, do not recommend it for that they speak not good for fibromyalgia.

  7. maureen at 5:42 am

    @Monica (and all), I love that you know of Dr. (EDITED) at the University of Michigan!
    About a year ago while researching… I came across Dr. (EDITED) video on FM.
    I felt like I hit the jackpot!
    I watched the video over and over, made a ton of notes and was abundantly educated by him!!!
    I recommend anyone with FM or any issue connected with FM to check him out.

  8. Monica at 7:07 pm

    This is rule of thumb protocol for the treatment of fibro. See the research of a pioneer in the field, Dan Clauw, MD.

  9. Marygrace Coneff at 8:51 am

    I was on narcotics for many years. Always searching for a different way to control the pain. Nine years ago, I found Low Dose Naltrexone. I had been bedridden for 2 years! I was on 14 medications! I got off 13 medications! I just recently got off my antidepressant. Cymbalta was horrible for me. And Lyrica made me gain weight. I was so groggy with these drugs.
    I still have some pain, but not like before. And I am doing so much better!
    Check out http://www.LowDoseNaltrexone.org. for more information.

  10. Gail at 1:45 am

    I was diagnosed 10 years ago by a rheumatologist who added that from my history I have been suffering with FM since I was very young, i am 52 now. I have very severe FM and it is complicated by 3 other conditions and being allergic to NSAIDS & CODEINE. I became bedridden for around 6 months after 3 big operations over about 8 years prior to FM diagnosis, my body just would not recover the third op. Since being diagnosed with FM after my brilliant GP suspected it and sent me to see my rheumatologist. Had hydrotherapy, physiotherapy, occupagional therapy involvment and have over the years tried many combinations of drugs. I am lucky in some sense because i have a team of health professionals, none of which have given up on me because of my willingness to try whatever they threw at me and give it a good time to take effect even though most made me worse. With gabapentin and pregablin I had huge weight gain very rapidly and with both, I felt I was losing my mind and perception of everything going on around me. I have not taken duloxetine as my surgery felt too expensive and not enough evidence to support use for FM. However I was given venlafaxine instead. Long story short, I am now with a pain management team and am on a cocktail of drugs and a lignocaine infusion every 6 weeks. I still get flare ups that are usually weather change related and its usually more the fatigue side of FM. I have accepted that I am always going to have pain and fatigue and sleep problems, but with management of the pain, it gets pushed back enough to give me some quality of life. So for my FM and it has taken several years to tailor what the combo for me is that gives me some sort of life.
    Medication:
    125mg amatryptaline
    75mg x twice a day venlafaxine
    20mg quinoric
    8 x paracetamol
    8x tramadol ( I now use these more as a back up when on a flare up or as infusion running down but always take 2 at night to reduce pain of laying in a position too long)
    25micrograms/hour transdermal patch fentanyl, patch changed every 72 hours
    Infusion lignocaine every 6 weeks given in theatre conditions, which I rest well for approx week after as get sleepy and can feel bit of a run down few days before next infusion.
    Temazapam as required for sleep when had really bad night’s and gets me back in better routine.
    Just as important as drug thearly is to have a good team of health professionals, GP, Rheumatologist , anaesthetis consultant in pain management with good understanding of FM.
    I also found mental health therapist helpful to coming to terms with how my life had changed and it was about accepting that and managing the condition and adapting, learning to live alongside this illness and good understanding of it makes it less frightening.
    Occupational therapist is useful for also helping you come to terms you may need to use a stick, Have aids around the house and adapt to doing things differently. Learning how to pace yourself and accept it for what it is.
    For me hydrotherapy and physiotherapy would wear me out, but easier to move in the warm water so now on flare ups I find good soak in bath n gentle movement of my joints in the bath helps. Or using shower to massage joints that are really tender.
    Distraction helps with pain whether it’s playing patience or colouring in, some good adult colouring books now, bit of sewing whatever you can manage.
    Lastly but not least, Good family and friends that are supportive and understanding of your limitations and how things can change on a daily basis so don’t add pressure or get upset when arrangements have to change, also just as important help when you need but still see you and not just the illness.
    Hope this is useful, I am on a flare up , the drastic weather change here has triggered it,we all get down sometimes, frustrated we can’t do what we want to, angry…. it’s all allowed, don’t beat yourself up, do what you gotta do to get through and try hard not to lose yourself and listen to your body coz you are the only one that truly knows what you feel. Good well-being to you all out there. Gail

  11. HJ at 6:29 am

    Cymbalta did something to me that’s hard to explain. I was on the first week of the drug and I suddenly felt like I’d hit a mental wall of brain fog. My co-worker asked if I was OK because my eyes kinda glazed over. I was typing on the adding machine, and my fingers wouldn’t do what I tried to get them to do. I drooled on myself and felt a panic but couldn’t put my thoughts together to talk. If I had to guess at what a stroke felt like, I would say that might be it. That’s just what it felt like, not what it was, apparently. I was so scared… Doc told me to discontinue the medication.

    As for Lyrica, I thought it was helping me. I had less pain. But then my friends started telling me I wasn’t the same. I was cancelling plans with them. Even though I had less pain, something was wrong. I don’t know if I was getting depressed, because it sneaked up on me, or if it was fatigue. I wanted to keep taking the medication, because I enjoyed having less pain, but it was obviously working against me. I asked the doctor if I could just use a lower dose. Doc said that I was on the minimum therapeutic dose as it was, so he advised me to discontinue it. In retrospect, it was for the best. I was also gaining weight, which really worked against my goals. It certainly wasn’t improving my life despite having less pain. I think I was slowly becoming depressed because of the medication.

  12. Mary Carrazza at 7:27 pm

    Dr Gilron & his colleagues would be better off turning their energies & resources towards real & productive research in an effort to design a PROPER & EFFECTIVE drug for Fibromyalgia. Not put a couple of currently useless drugs together and call it
    Reaearch.

  13. Chris at 7:14 pm

    I really wouldn’t call this novel – and improving outcomes in treatment isn’t saying a whole lot since outcomes are so dismal already. Throwing serious drug combinations like this at a poorly understood condition is not progress. And research does not support the dogma of a central nervous system disorder – research seems to indicate dysfunction in the immune system and peripheral nervous system. The best treatments are immune therapies not this same old recycled garbage.

  14. Judith at 3:56 pm

    These two dangerous drugs sent me to the ER! They did absolutely NOTHING for pain. STOP making patients try these killers!

  15. Sue Maharaj at 2:11 pm

    I developed fibromyalgia after a really bad case of rubella more than 20 yrs ago. I had pain from head to toe and lots of melds n injections which gave temporary relief only. 4 years ago an accident left me with 2disc protrusions at the lower end of my spine L5/ S1, which resulted in a cyst forming on the sciatic nerve. All kinds of drugs and treatment were administered none of any help to ease the pain. Not even morphine or pethadine could ease the pain. An emergency op to the spine with nuts ,bolts and rods changed my life forever. The op was a success but the fibromyalgia became so Aggressive that it left me disabled to perform my job as an educator. Lyrica and Cymbalta was prescribed by my surgeon and psychiatrist respectively. It did Nothing to ease the pain but left me with bills upon bills as Lyrica is not covered by Bonitas. I had to learn how to get out of bed, Sit ,stand and walk as a kid would. Every movement brought upon pain and still is. These 2 drugs messed up my whole body and life. I put on 18 kgs, became diabetic due to sedentary lifestyle and hypertensive . My thyroid problem coupled with Lyrica and Cymbalta set me back so badly that I’ve become a recluse and totally dependent on a walking aid and my family. These drugs have been around for 7 years as a previous physician prescribed same. I can’t remember stuff, forget words and names in mid sentences, can’t recognize people , forget anything I read as fast as I read it, etc . I get up , pass through the day and go to bed in pain. Increasing the dosage was trial and error which left me worse . Today, I’m medically boarded and do not enjoy any quality of life because of my physical and psychological trauma. I would never wish the side effects of Lyrica and Cymbalta on anyone. It’s the worst drug I’ve ever taken. To date, I’m battling to find myself as the side effects out weigh the pain . Physicians do trial and error treatment, nothin which has worked to relieve the daily agony of fibromyalgia pains. To all who really want to try this combination, investigate case studies before settling upon a decision . It’s certainly a hopeless drug which leaves you helpless and in the Pitts.

  16. Layla Rose at 1:59 pm

    When I was suffering from all these symtpoms, I took cymbalta, which had no effect on me whatsoever. And I refused to take Lyrica b/c of the side effects. I was not about to subject msyelf to ongoing steroids and the effects of that. Glad that I discovered it wasn’t FM after all. I just don’t see this as that much of a breakthrough either, as someone else said: just putting 2 old meds together, doesn’t necessarily equal a great recipe for treatment.

  17. connie at 12:21 pm

    Doctors and the press will tout this garbage while decrying the drugs that have given me a life worth living for many years. I have been successfully used fentanyl and dilaudid but am in the process of being weaned off both because a few idiots use them for recreational purposes. My quality of life is heading downhill. I wonder what the knee jerk response will be when it becomes common knowledge that some people misuse and die from lyrica and cymbalta? Those poor people who successfully take them for pain relief will be in the same hell those of us who have had opiates taken away are currently in!

  18. cindy deim at 10:57 am

    This just cracks me up. New treatment ha. they are just trying to get rid of the old cr*p that doesn’t work.

  19. Mary Mell at 10:02 am

    AMEN to the withdrawal that no one bothers to tell you about and then the same doctors who push these vile drugs at you do not want to treat the withdrawal. Will never ever take either drug again.

  20. Joy at 8:26 am

    Fibromyalgia sounds similar to CRPS. CRPS has a new device out similar to the spinal cord stimular. The Axium stimulates the DRG. There is a current trial with Neridronate. This drug is available already in other countries. If fibromyalGia is indeed do to the spinal cord/brain these will work.

  21. connie at 8:26 am

    Those findings are great for those who can take Lyrica and Cymbalta but sadly do not adress those of us who have severe adverse reactions to those drugs. I tried them years ago and still have problems with my eyes that began within a week of starting them.

  22. Nicole Hervieux at 8:19 am

    This not a new discovery or fantastic news… I have Fibromalygia and ME and was given this treatment of cymbalta and Lyrika 5 yrs ago by my rheumatologist. I developed a huge allergy to the medication combo, and what is called seretonin reuptake syndrom. I had the to taper the medication to nothing. Afterward came the withdrawal… Let me tell you that I was never so sick in my life! I am a registered nurse, I know how my body and brain works. I knew I was in withdrawal from the medication cessation. It took 3 months of pure hell, tripling my omega 3 for the brain zapping that was happening every 3-5 minutes, my body burning up, throwing up, migraines, perspiration +++ I could go on and on… It lasted 3 months. It is all great to imagine a fit for all cure, except that Fibromalygia is very individualized and people gets it at different levels. I have it really bad for my age. (it started when I was 48 yrs old). The doctors don’t bother telling you of the withdrawals if you need to get off the medications. That should be theirs first priority with Fibromalygia patients because we don’t do well with medication in general. No medications has worked since, and I have been bed ridden for 5 yrs. I lost 5 yrs of my life! Exercise exasperate it, and I get sicker everytime I do some minor things. I am stuck in a broken body. I can’t work anymore, I can do anything in the house, I am so tired, nauseous, in pain all the time, it is no way to live.
    But don’t make me laugh with a new discovery for Fibromalygia… It is once more to push the pharmaceutical industries and fill theirs pocket with money. I, for one know that that combo don’t work to cure or even get better. But it made me sicker if anything else. That is false advertisement, and giving hope to people for nothing when you know it is not a cure at all! People in my condition are miserable and don’t need false dream. That doctor is a fake, he did not found out about those two medications, as I said 5 yrs ago that is what I was given when diagnosed. It did not work for me and won’t work for others. Please stop publishing things like that, it gives people false hope. It is not fair.

  23. Jean Price at 7:42 am

    Wondering if anyone here has tried this, and if it helps….and do we have a center dedicated to pain research? The individuality of people and even types of pain within the same person must make research difficult. I know personally that a low dose Cymbalta was like a miracle for some nerve pain in my foot from a post surgery reaction to one nerve block site. It reduced the pain and burning well over 50%…yet it didn’t touch any of the neuropathy in my leg and arms from mutilple back and neck surgeries! I hope this does help people with fibromyalgia…it is such a debilitating, draining pain and affects so many! It’s the kind of pain that is hard to distract from, and the fatigue and other symptoms add to the nightmare!

  24. Steve at 7:29 am

    Piddling around with two old meds that don’t work well and combining them is not the same as vigorous research into causes and effective treatments for FM. Just mixing mud and throwing it at the wall IMO.

  25. JRL at 7:15 am

    I couldn’t tolerate the side effects of Lyrica. And Cymbalta made me feel like I was walking on the moon.

    Either one or a combination of the two may be effective for some but not for me.

    In future studies, I believe an individualized approach will be found to be the most effective treatment protocol.

  26. Maureen at 6:20 am

    I sure can appreciate the ongoing research and coming up with this treatment since I suffer from Fibromyalgia (mine is secondary to my chronic spinal pain issues).
    I don’t mean to come across as negative, but personally, I’ve had separate experiences with both of these drugs for my spinal nerve pain and nearly ended up in the ER with each, from horrific side effects.
    I cannot imagine being on both at the same time.
    But, I am one of those people who is hypersensitive to a lot of drugs.
    Although, my primary doc and I are experimenting with the combo of Celebrex and an Antiviral for the increased episodes of chronic fatigue I was having and for my general spinal arthritis and nerve pain. I do have minor side effects from the Celebrex but I can tolerate it.
    I’ve been on both daily for 2 months now and YAY! it’s helped greatly!!! It’s been remarkable.
    Now, if only I could get my ‘pain management doc’ to work more effectively on my overall pain issues and meds with me!
    I wish all ‘feel better’ days ahead. Maureen

  27. Mary Mell at 3:21 am

    While this may seem hopeful to some, I cannot imagine the side effects of combining Lyrica and Cymbalta. Alone, each has its own nasty side effects I’ve hardly not known any one that has taken either one that had not experienced them. When Lyrica first came on the market seemed like every Dr I went thought it was going to cure me. Then came the side effects, including 18 pound weight gain the first month. Not worth it.
    And Cymbalta, forget to take it just one day and it will happily remind you!!!
    I will suffer from the pain before I suffer from these chemicals.