When it comes to fibromyalgia think pain. Almost constant pain. Some people describe it as a nagging ache, sort of like a toothache in your muscles. Other people complain of tender places on the body. These trigger points may be at the base or back of the neck, the upper and lower back, as well as the hips and buttocks. Some people experience sensitivity around the elbows or the chest. When you experience this kind of unrelenting pain the quality of your life suffers. Needless to say, people want fibromyalgia treatment that works. They should not have to choose between pain relief and memory loss. That is this person’s dilemma.

Fibromyalgia Treatment with Alprazolam (Xanax)

Q. A couple of years ago I was diagnosed with fibromyalgia and arthritis. The rheumatologist questioned me about my sleep patterns and prescribed alprazolam at bedtime.

The result was dramatic. The fibromyalgia pain disappeared within a few days. There was no impact on the arthritis pain.

Aside from the pain, I am in excellent health at 75 years of age. However, I am concerned about my memory. Does alprazolam contribute to memory problems? Must I choose between pain relief and memory?

Sleep Problems and Fibromyalgia:

A. Sleep is critical for managing fibromyalgia. This mysterious condition produces pain in soft tissue, frequently associated with tender spots. Fatigue and trouble concentrating are also common symptoms.

For reasons that are somewhat mysterious, people with fibromyalgia often complain of serious sleep problems. They frequently have trouble falling asleep and staying asleep. Chronic insomnia becomes a way of life. They are sleep deprived and exhausted.

Is chronic insomnia the chicken or the egg? In other words, does poor sleep cause fibromyalgia or does the pain of fibromyalgia cause insomnia?

We are not equipped to answer that question. We can say that one sleep expert, Martin Scharf, PhD, told us two decades ago that gama-hydroxybutyrate (Xyrem) was helpful in restoring normal alpha sleep and was an effective fibromyalgia treatment (Journal of Rheumatology, Nov. 1998).  The FDA approved Xyrem for narcolepsy (in patients with cataplexy and excessive daytime sleepiness), not as a fibromyalgia treatment.

Alprazolam as a Fibromyalgia Treatment:

Treatment with a benzodiazepine sedative such as alprazolam (Xanax) can pose problems, especially for older people. Such drugs may increase the risk of dementia (Expert Opinion on Drug Safety, May, 2015).  Alprazolam, along with other benzos, is on the list of potentially inappropriate medications for seniors.

Our Guide to Drugs and Older People offers more information about such medicines. Anyone who would like a copy, please send $3 in check or money order with a long (no. 10) stamped (71 cents), self-addressed envelope:

  • Graedons’ People’s Pharmacy, No. O-85,
  • P. O. Box 52027
  • Durham, NC 27717-2027

It can also be downloaded for $2 from the website in our Health Guide Section.

Other Fibromyalgia Treatment:

There are no ideal treatments for fibromyalgia. Doctors prescribe drugs that affect brain chemistry such as pregabalin (Lyrica), duloxetine (Cymbalta) or milnacipran (Savella).

Reports from Readers:

Visitors to this website have shared their stories with drugs like Lyrica. Here are just a few examples:

Teresa shares this experience:

“I have been on Lyrica for about nine years for fibromyalgia. I have been experiencing increasingly disturbing memory issues, suicidal thoughts and brain fog. I have also been irritable and irrational. I have made really poor decisions, withdrawn socially and struggled at work.

“My fibromyalgia pain has not been particularly manageable since a car accident in January. After some research, I have concluded that I have most likely been endangering my health by taking these medications. (I have also been taking Topamax for migraines for years.)

“I know that part of the issues I am experiencing can be due to the combination of medications together, but I feel that a fresh start must happen for me. I am down to 200 mg of Lyrica and counting. Yes, it is extremely unpleasant! My pain level and fatigue are really high, but so far I am not experiencing the sweating that others complain about.”

Catherine is caught between the classic rock and a hard place:

“I was prescribed Lyrica when I was first diagnosed with fibromyalgia. I couldn’t handle the side effects (brain fog, balance issues) and the cost.

“My doctor switched me to gabapentin without really telling me about the side effects. I wish I had known about the mood effects before I attempted suicide. I never put two and two together for a long time.

“I was given diazepam to counter the irritable moods gabapentin produced. This worked well until I had to go off the benzodiazepine. The terrible mood swings, the irritability, and angry outbursts are becoming unbearable. But, the pain from the fibromyalgia is controlled with gabapentin, so I do not know what to do.”

Shilo experienced terrible withdrawal symptoms on stopping Lyrica:

“I’ve been taking Lyrica for fibromyalgia two years. I started tapering two months ago and it’s living a new hell. I recommend nobody take this drug at all. Worst withdrawal symptoms I’ve ever experienced. I felt like I was dying.”

Nondrug Fibromyalgia Treatment:

Nondrug approaches such as acupuncture or massage therapy may be helpful (Systematic Reviews, May 15, 2017). 

How to Ease the Pain of Fibromyalgia with Acupuncture

How to Ease the Pain of Fibromyalgia with Acupuncture

Easy Acupressure Trick Helps Fibromyalgia Sufferer Overcome Insomnia

Easy Acupressure Trick Helps Fibromyalgia Sufferer Overcome Insomnia

Practicing yoga or tai chi, a gentle movement program, might also ease fibromyalgia discomfort.

Mindfulness training can be helpful for insomnia and fibromyalgia (Frontiers in Psychology, Aug. 3, 2018).

Could Vitamin D Be a Lifesaver for Fibromyalgia Pain?

Could Vitamin D Be a Lifesaver for Fibromyalgia Pain?

Share Your Own Fibromyalgia Treatment Story

Please let others know your experience with drugs prescribed to treat fibromyalgia. How well did they work? Did you experience any side effects? Have any nondrug approaches been helpful? People with fibromyalgia could benefit from your story in the comment section below.

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  1. KarenB
    Alberta Canada
    Reply

    I was diagnosed with fibromyalgia in 1982 by a arthritic doctor. I tried many things to improve my condition, continued to work on and off with months of chronic fatigue syndrome in between working. In 2012 had my left Thyroid removed and put on Synthroid (T4), but it never seemed enough to correct my condition.

    In 2015 menopause took me by storm; I became almost incapacitated, terribly cold, depressed and super tight muscles that 3 visits a week to chiropractic couldn’t undo. No doctors would listen to my complaints and they had me on anti depressants which made me suicidal, and put me to bed.

    Finally a new naturopath of integrative health opened near by. I took my so called thorough blood tests and MRI from the doctors and past history and had more blood work done. Doctors don’t test free T4 or free T3 and antibodies which is all it took for my diagnosis of T3 deficiency. After taking 10 mcg of Cytomel (Liothyronine) for several weeks, I became a new person-describing it as “time has changed for me” my muscles relaxed, my constipation disappeared, I am not cold all the time, my brain fog and anxieties, and depression went away. I sleep properly, deeply and wake up rested! I could carry on, but you get the idea- I had a proper diagnosis- extremely validating to me. Also my menopause extreme symptoms became normal and bearable. The anti depressants were the wrong medication, pushed upon me by several doctors, through the years, as the diagnosis.

    This changed my life and I urge others to have their thyroid properly tested by a naturopath, as medical doctors, both in Canada and US, will still tell you this is very rare and will not test for it. I have read the thyroid can be easily damaged through physical and mental pain, and anguish, and stress, which is what happened to me at 10 years of age. I am now a new person discovering life through new eyes. I hope my story helps others. The diagnosis of fibromyalgia was a stumbling block, a put in a box diagnosis for me and never an answer.

  2. Lynda
    Puget Sound, WA
    Reply

    I was diagnosed with what was called Chronic Fatigue Immune Dysfunction Syndrome/Fibromyalgia in 2000 – CFS is now called Systemic Exertion Intolerance DISEASE by the NIH, WHO, CDC and major teaching hospitals in the US, as well as around the world. I was seen by a leading expert in the field, and after testing the efficacy of many drugs, Alprazolam (Xanax) worked well for me. I’ve been taking Alprazolam for 19 years, began at 9, .5 mg tabs, reducing it shortly thereafter to 2.5, .5 mg daily, with no need to increase the dosage, and it works very well for me.

    I was vilified for years as being a lazy person who wanted to be on government assistance. I have never been on any form of governmentsState assistance. Recently my PCP stated grave concerns regarding use of Alprazolam and the eventual development of Alzheimer’s, as I’m now 74. I don’t believe the results of the studies, at least in my particular case, and so I took a SAGE memory test and passed with flying colors. Both parents had Dementia/Alzheimers, and so I understood my PCP’s concern. I have also taken four on-line classes at Harvard and one at Georgetown University, all resulting in top grades.

    It is my belief that because Alprazolam is a controlled substance, that the government wants all patients off controlled substances, replacing them with other medications, that for me, do not work. For me, Gababentin, Lyrica and Cymbalta cause memory loss, dizziness and fatigue.

    After years of MDs rude and condescending comments, I took it upon myself to see a Psychiatrist, who believed that Alprazolam was the answer to my health issue(s). MDs in my state must justify prescribing controlled substances or potentially loose their licenses to practice medicine, and so I feel fortunate to have an MD who can think outside the box. I did choose the proper specialty to see as a patient, even though I have no psychiatric issues. It’s rare in my state for anyone to be prescribed a controlled substance unless short-term use is needed after a surgical procedure, and the Opioid Crisis, in my opinion is predominantly caused by street drugs, not prescriptions in my state. I’m sure there are still MDs who prescribe outside of the government guidelines, and they should and will be dealt with accordingly.

    The one-size-fits-all theory of prescribing medications is a fallacy, and PCPs should have the right to treat their patients on an individual basis, which is now ancient history.

    Take the SAGE test, read, engage your brain as you are able, and keep the neuroplasticity of the brain as best you can – use it or lose it, and seek assistance – your illness is real. Until further valid studies have been completed, it’s my opinion that Alprazolam should be allowed as a prescribed medication to treat Fibromyalgia, until big pharma develops a medication that truly isn’t addicting, and that works well for chronic and intractable pain. At present, people have nowhere to turn to acquire relief from exquisite pain, which is inhumane.

  3. Sandra
    AL
    Reply

    I had enjoyed your news letter until recently. Now all it seems this column wants to do is sell it books, etc. Therefore I am going to opt out of any future letters. Thank you.

  4. Mary
    NORTH CAROLINA
    Reply

    Fibromyalgia is a multi-faceted condition which truly requires individual assessment for each person. In the past 35 years, I have observed this syndrome before it was named and described and today, the numerous peer-reviewed research and articles that are available to any interested physician or layperson.

    This is a condition that you might want to consider seeking a Licensed Acupuncturist who is schooled in all aspects of Chinese Medicine. This syndrome was recognized by the AMA in the late 80’s and since then I have watched the evolution of treatments
    for fibromyalgia.

    It is necessary to assess, not only the pain, but the physical experience by the patient of that pain. For example, is the pain constricting, felt like a knife, characterized by heaviness that worsens with barometric pressure changes, or experienced more than cold or hot weather. All of these differences, which appear to be minor to some are essential to differentiate in Chinese medicine which can be one of the most effective complementary treatments for Fibromyalgia. Find a Licensed Acupuncturist that is trained, not only in Acupuncture, but their training included, Tuina and Chinese herbal medicines.

    I have seen Integrated treatments using these modalities be extremely successful in resolving Fibromyalgia.

  5. Donna
    US
    Reply

    Years ago my then-doctor recommended that I take magnesium with malic acid to alleviate fibromyalgia pain. He explained that it was thought that in fibromyalgia the myelin sheath over a muscle would contract independently of the muscle; the myelin sheath would contract when the muscle itself did not. It is certainly worth having your doctor check your magnesium levels; if low, this may be contributing to fibromyalgia pain.

  6. Anthea
    TX-Texas
    Reply

    Having gone the pharmaceutical route (Effexor) for a number of years for fibromyalgia, I began having unwanted side effects. So the following works for me: I have tried various diet modifications but the best diet intervention for me was to stop sugar and simple carbs. Possibly inflammatory reaction? Despite the grim initial few weeks of beginning a very low-key exercise regimen 25 years ago, I am now, at almost 70, in the gym using weights, machines, and cardio equipment five days a week. The effort is not the issue now, but my body’s tolerance over the next 48 hours. I know other FMers empathize with that feeling of going from up and lively to being run over by a bus in a short time span after exertion. Enter CBD – it has been a great help in allowing exercise tolerance. Just do your homework before buying, lots of snake oil out there. In addition, I find it provided a mental lift (NOT like caffeine) but increased clarity of thought for a longer time frame. I use chelated magnesium at bedtime and really notice the difference in sleep if I run out.

  7. Susie
    WI.
    Reply

    I was in relentless pain for at least a decade. Pain made sleep difficult to sustain, and the mental fog was horrible. I was diagnosed with Fibromyalgia. I spent another decade living with the pain. I did not take medication because at that time they were not prescribing much. Fibromyalgia was rather new at the time.

    Then, as I am a loyal listener to your program from the early days, I heard the first program with the Doctor who spoke about gluten issues. He described every symptom that I had. I decided to try a diet change. I loved good bread so this was uncomfortable, and I decided to do one 24 hr period. I did that and another 24 and another. By 72 hrs I knew things were improving. After 72 hours things continued to get better slowly over a period of about a year. At that time they were not doing much testing either. That was about 18-20 yrs ago.

    I am 76 now and feel better than when I was in my 40’s. ALL, and I mean ALL my symptom are gone. It never was fibromyalgia. There were very few gluten-free products available at the time so I just went with unprocessed foods that would not have hidden gluten. Lots of fresh fruit, no cooking necessary. I am so grateful to have heard that program. It changed my life. I do not miss the gluten foods because I remember how bad it used to be. I was still working at the time, and the mental fog was debilitating. Every mental task took twice as long. If I can encourage anyone to give gluten free a try I would be so happy. Do it 100% in order to get a good comparison. Good luck!

  8. Sissy
    North Carolina
    Reply

    I have had fibromyalgia for years. I tried most of the standard treatments—Lyrica, gabapentin, Cymbalta. I was still miserable with pain, fogginess, and other side effects. I finally started researching myself. I found low dose naltrexone. I asked my rheumatologist about it. He told me he did not prescribe opioids (ldn is not an opioid). I then asked my primary care doctor. He actually said he had heard of it and wrote a prescription to a compounding pharmacy, starting at a low dose. I could tell I was improving within a month. Foggy days and pain levels were lessened. A few years later, I am much improved. Not cured, but it’s the difference between night and day, and I could not be more grateful. The ONLY side effect was insomnia for the first few weeks, which now I understand could have been alleviated by taking LDN in the morning, instead of at night. I will never stop taking my LDN.

  9. T
    Boone, NC
    Reply

    After 5 years of drug reactions an old drug from Great Britain was finally allowed in the U.S., and upon taking it, gave me total relief. It did make my blood pressure rise (to normal levels). I weaned off of it after a year of taking it and switched to natural remedies. After CBD became available, I began taking it. That, along with a low-carb diet, makes me sleep well and have much less inflammation which relieves the various types of psoriasis and IBS which have plagued me for years. I do to have to deal with all the side effects and warnings of “modern pharmaceuticals” which usually lead to more medications to combat their side-effects.

  10. Annie
    Michigan
    Reply

    I would really like for The People’s Pharmacy to discuss the supplement that is recommended for pain that is shortened to PEA, for Phenylethylamine. My reading of materials I have found online is that it is safe and effective for chronic pain. Can you discuss this supplement please?

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