Fibromyalgia treatment is commonly treated with antipsychotic drugs, which are also known as neuroleptics, are typically used to treat psychotic conditions such as schizophrenia, bipolar disorder, depression and anxiety. While they have not been studied for their use in insomnia or chronic pain, sometimes they are used to treat these conditions as well.
Problems With Antipsychotic Drugs
There are a lot of people who don’t want to take antipsychotic medication without having a psychosis diagnosis. To them it is as though the doctor thinks that they are crazy. While this may sometimes be true, there are lots of other valid reasons for using antipsychotic drug therapy in treating things like chronic illnesses that are not of a psychiatric origin.
It is important to understand the difference between the older (“typical”) and newer (“atypical”) antipsychotic drugs. The “typical” antipsychotic drugs work by blocking the dopamine receptors that are located in your brain, which are thought to cause psychosis’ numerous symptoms (i.e. hallucinations, delusions). On the other hand, the “atypical” antipsychotic drugs (i.e. Risperdal, Abilify) also block 5-HTP serotonin receptors. For this reason several of the “atypical” antipsychotic drugs have been used as fibromyalgia medication.
Unfortunately, most of the antipsychotic drugs (i.e. tricyclic antidepressants) are not all that selective whenever it comes to these receptors. Therefore, they will oftentimes block histamine and acetylcholine receptors as well. This is why both their effects and their side effects can be so different from one another.
One of the main problems with these types of fibromyalgia drugs is that they can cause major side effects, including:
- Sleepiness
- Tardive Dyskinesia (involuntary movements)
- Severe weight gain
- Neroleptic Malignant Syndrome (a life-threatening neurological disorder that occurs whenever someone has an adverse reaction to these medications and whose symptoms include muscle rigidity, fever, autonomic instability and cognitive changes such as delirium)
Whenever these drugs are used as fibromyalgia medications the dosage is usually quite small. Therefore, the major side effects will not be as likely to occur. However, there are still other medications for fibromyalgia (i.e. Xyrem, low dose naltrexone) that are safer and thus you may want to try first.
Olanzapine (Zyprexa)
Zyprexa has been used in treating various conditions – everything from PTSD to chronic headaches. It works by blocking the 5-HTP serotonin receptors. This mode of action is oftentimes quite helpful for fibromyalgia patients. In fact, there have been several papers written about this medication for fibromyalgia. One of these papers came to the conclusion that Zyprexa will help 43% of fibromyalgia patients. However, this medication does have a lot of side effects that you should know about, including:
- Rigid muscles
- High fever
- Tremors
- Sweating
- Confusion
- Fast or uneven heartbeat
- Slow heart rate
- Feeling like you might pass out;
- Twitching or uncontrollable movements of your eyes, lips, tongue, face, arms, or legs
- Trouble speaking
- Trouble swallowing
- Dry mouth
- Thirst
- Feeling very hot (with or without sweating)
- Urinating less than usual or not at all;
- High blood sugar (you will know that this is occurring because you will have increased thirst, loss of appetite, fruity breath odor, increased urination, drowsiness, dry skin, nausea, and vomiting)
- Sudden numbness
- Sudden weakness
- Problems with vision
- Problems with speech
- Problems with balance
- Fever
- Chills
- Body aches
- Flu symptoms
- Sores in your mouth and throat
- Swelling in your hands or feet
- Changes in personality
- Unusual thoughts or behavior
- Hallucinations
- Thoughts of suicide
- Upper stomach pain
- Itching
- Loss of appetite
- Dark urine
- Clay-colored stools
- Jaundice (yellowing of the skin or eyes)
- Weight gain
- Increased appetite
- Headache
- Dizziness
- Drowsiness
- Feeling restless
- Memory problems
- Stomach pain
- Constipation
- Loss of bladder control
- Back pain
- Pain in your arms or legs
- Numbness or tingling
- Breast swelling or discharge
- Missed menstrual periods.
Risperidone (Risperdal)
Low doses of Risperdal is sometimes used for treating depression and anxiety. Some have also reported that it is helpful for treating fibromyalgia. One of the biggest benefits to using this antipsychotic medication is that it isn’t as prone to causing weight gain as most of the other ones are. Some of the side effects that you may experience here include:
- Anxiety
- Constipation
- Cough
- Diarrhea
- Dizziness
- Drowsiness
- Dry mouth
- Fatigue
- Headache
- Increased appetite
- Increased saliva production
- Indigestion
- Lightheadedness
- Nausea
- Restlessness
- Runny nose
- Stomach pain or upset
- Trouble sleeping
- Vomiting
- Weight gain
- Severe allergic reactions (rash; hives; itching; difficulty breathing or swallowing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness)
- Abnormal thoughts
- Confusion
- Drooling
- Fainting
- Fast or irregular heartbeat
- Fever
- Chills
- Persistent sore throat
- Inability to control urination
- Increased sweating
- New or worsening mental or mood changes (i.e. aggression, agitation, depression, severe anxiety)
- Seizures
- Severe dizziness
- Stiff or rigid muscles
- Suicidal thoughts or attempts
- Symptoms of high blood sugar (i.e. increased thirst, hunger, or urination; unusual weakness)
- Tremors
- Trouble concentrating
- Trouble speaking
- Trouble swallowing
- Trouble sitting still
- Trouble walking or standing
- Uncontrolled muscle movements (i.e. arm or leg movements, twitching of the face or tongue, jerking or twisting)
- Unusual bruising
- Vision changes.
Quetiapine (Seroquel)
A lot of countries will use Seroquel more off-label than on-lable. It is mainly used for sleep because it has extreme sedative properties. In one study it was shown to be effective for fibromyalgia patients who were suffering from fatigue and stiffness. However, it is important to note that it didn’t help to alleviate pain in these people. Another study was also done in which Seroquel was combined with the use of Lyrica. It too had good results even though a lot of people did drop out of this study. With this medication you may experience the following side effects:
- Dry mouth
- High triglycerides
- Weight gain
- Headaches
- Agitation
- Dizziness
- High cholesterol
- Fatigue
- Weakness
- Constipation
- Indigestion or heartburn
- Nausea
- Vomiting
- Increased appetite
- Lethargy
- Nasal congestion
- Abdominal pain (stomach pain)
- Back pain
- Shakiness (tremors)
- Irritability
- Joint pain
- Sore throat
- Fever
- Rapid heart rate (tachycardia)
- Irritated or runny nose
- Vision problems
- Signs of diabetes (i.e. high blood sugar, increased thirst, frequent urination, extreme hunger)
- Large or rapid weight gain
- Suicidal thoughts
- Dizziness or fainting when going from a sitting or lying-down position to standing
- Feelings of internal restless or jitteriness
- Any abnormal muscle movements (these abnormal movements can become permanent if this medication isn’t stopped quickly)
- Signs or symptoms of neuroleptic malignant syndrome (i.e. a high fever, stiff muscles, confusion, irregular pulse or blood pressure, an increased heart rate (tachycardia), sweating, irregular heart rhythms (arrhythmias)
- Signs of an allergic reaction (i.e. unexplained rash, hives, itching, unexplained swelling, wheezing, difficulty breathing or swallowing)
- Anemia
- Vertigo (a spinning sensation)
- Increased or decreased sex drive (see Seroquel Sexual Side Effects)
- Teeth grinding
- Neck pain
- Yeast infection
- Increased salivation
- Gas
- Hemorrhoids
- Canker sores
- Migraine headaches
- Cough
- Eczema
- Impotence, also known as erectile dysfunction or ED
- Dry eyes
- Tinnitus (ringing in the ears)
- Low thyroid (hypothyroidism) or overactive thyroid (hyperthyroidism)
Amisulpride (Solian) And Sulpiride (Dolmatil)
Solian and Dolmatil are not only used for treating psychosis but they are also approved in some European countries for the treatment of dysthymia (mild, chronic depression). These medications have also been shown to relieve anxiety, vertigo (dizziness) and tinnitus (ringing in the ears). Some people have found both of these medications to be a sedative. On the other hand, there are also others who have found both of these medications to be a stimulant and thus relieve them of their fatigued feeling. Unfortunately, neither Solian nor Dolmatil are available in the United States or Canada today. However, you may still wish to know that the side effects do include:
- Lowered blood pressure
- Cardiac arrest
- Sudden death.
- Hyperprolactinaemia
- Malignant syndrome (a fatal allergic reaction to this medication or others like it)
- Weight gain
- Increase in liver enzymes
- Sedation or drowsiness. Insomnia has been reported.
- Tremors
- Hypertonia (an abnormal amount of muscle tension that prohibits the muscles from stretching)
- Hypokinesia (decreased bodily movement)
- Hypersalivation
- Acute dyskinesia and dystonia (spasms in your muscles)
- Akathisia (inner restlesness)
- Tardive dyskinesia (i.e. rhythmic, involuntary movements primarily of the tongue and/or the face)
- Convulsions
- Galactorrhoea (excessive flow of milk from your breasts)
- Amenorrhoea (the absence of women’s menstrual periods)
- Gynaecomastia (the abnormal development of large mammary glands in males resulting in breast enlargement)
- Breast enlargement and pain
- Rash
Why Antipsychotic Drugs May Work
There are a few theories as to why antipsychotic drugs may work in the treatment of fibromyalgia. One of the theories is that the lack of dopamine in a person may cause them to develop the symptoms of fibromyalgia. While it may seem strange that a drug that further reduces the action of dopamine would be used in the treatment of fibromyalgia, small doses of these medications do actually increase the levels of both dopamine and serotonin within a person’s brain. This is believed to be helpful for fibromyalgia patients.