To my FibroFriends

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I am doing much better and I think it’s mostly an anti-anxiety/depression medication (medically know as SSRIs: selective serotonin re-uptake inhibitors.) There are different drugs within this family: lexapro, celexa, wellbutrin, zoloft, prozac and they all do the same thing – more happy juice in the brain because it makes your brain keep extra serotonin floating around. Serotonin is a powerful neurotransmitter that has many many jobs in the brain only one of which is mood enhancing. SSRIs provide extra help in the brain to calm us, make us feel happy, reduce panic/anxiety, and help relieve a little of the pain. The SSRI I LOVE is Lexapro. I used lexapro before for panic attack while in college for 5 years and it really helped me feel like a better version of myself. But last Aug when my fibro start and was HORRIBLE they took me off of lexapro to do lyrica than cymbalta… and so on.  When my panic attacks came back in May I asked the doctors to put me back on it. They said I could combined it was the cymbalta. Well with the lexapro I finally started to feel like more like my old self not fibrocrazy lady. So as an experiment (and not telling my doctors) I stopped taking my cymbalta and figured out that in my opinion it was making me crrrraaaazzzy and more bad mental days made me more stress, depressed, and was causing more PAIN. So for a 2-3 months I just had lexapro and felt more like myself than I had in the past year. After going off the cymbalta I realized it really was helping with pain but honestly, it was making me hear and see things, have moodswings, black out, forget everything… it was antagonizing my fibrofog to the point where I couldn’t function. Thats when I starting researching both Cymbalta and Savella (the new fibro drug):

Cymbalta works with serotonin like lexapro but also works with norepinephrine (basically a natural painkiller with the downside that too much cause effects similar to an adrenaline rush and that makes fibrobodies have more pain.) It is made for people with rheumatological pain like arthritis. But balancing norepinephrine is hard to do especially for someone with fibromyalgia that I 100% believe is caused by false signals in the brain. I believe the cymbalta was causing way more problems while muting/helping with pain. If fibro was just about pain I think I could manage it… its the rest of craziness that overcomes me! =)

Savella is similar to cymbalta but it was created for fibromyalgia pain and they better balanced the selective serotonin and norepinephrine re-uptake inhibitors (SSNRIs – the chemicals that force your brain to leave extra serotonin and norepinephrine floating around) just for our fibrobrains so that it helps with pain but doesn’t make you fibrocrazy.

Now anytime you take medications that work on serotonin (SSRIs) there are side effects. Most of them go away within 3 weeks and are gone for good. Lexapro causes me to not be able to sleep until my body gets really used to it. Some people feel nauseous, some get some headaches but those usually go away within the 1st week. Before I found that lexapro worked best for me I tried 2 other SSRIs which one i don’t remember the name of which gave me lots of side effects and then celexa worked great but they let me try Lexapro when it first came out and it worked better, so it is normal for one med to cause many side effects and another not – they are all tweaked differently because different people respond differentially. The research I’ve done says lexapro seems to cause the least amounts of side effect and for a shorter amount time because the molecules have been split by light to remove unnecessary molecules that seem to cause side effects but i’m parcel because I love lexapro. Hahaha. My friends Sara who’s a nurse loves celexa (which I liked) because it doesn’t make her nauseous.  There are some who still swear wellbutrin is the best. Another is Prozac is one of the oldest so it has more side effects (the newer drugs have been made to reduce side effects and improve function.)

Anyway, my point is even though SSRIs are labeled as “antidepressants” they work for countless other illnesses because serotonin works on much more than just happiness in our bodies. I think it could be a great place for you to start if you are sensitive to medication but need help managing the fibro.

Now SSRIs can be difficult to get on so I highly recommend starting very slow to reduce side effect (medical word for doing this is titrating.) Slower than even the doctor my suggest.  When I started back on Lexapro I did this: for the first week i take 1/4 of the dosage (mornings if it causes sleeplessness/night if it cause nausea.) Week 2: 1/4 in the morning and 1/4 at night (totally 1/2 dosage;) Week 3: 1/2 dosage at one time – your preference for morning or night; Week 4 and on, If I think I need more time for the side effect to get better I stay another week and 1/2 dosage. If you want to slowly step again, I’d take 1/2 dosage when you prefer and 1/4 dosage 12 hours later. If you think your ready to go (a lot of people can just jump from 1/2 to whole in a week or two,) take the full dosage at your preferred time and if you think you need to stretch out each step to 2 week, do it. Its just like drink alcohol – if you drink the whole bottle you’ll be puking and dying! But if you build up your tolerance slowly, you can drink like a champ 🙂

Right now I am taking lexapro 40 mg. I started the Savella last month. I think it was working by muting pain but I ran out of the starter pack and my pharmacy had to order the refill since it’s so new, so I’ve been off it for about a week and hope to pick up the refill today. I’m not sure if it’s working wonders yet since I was on a very slow introduction (just like my lexapro example above), but it isn’t making me worse! I had one week at 50mg and now with this refill I am continuing at 50mg (1/2 the recommended minimal dosage of 100mg) because I am taking it with lexapro (they work together so I may never need a high dosage). I am hoping that combining these two drugs will continue my success with serotonin therapy but give me just the right amount of norepinephrine without all the nasty side effect cymbalta gave me. (and talking with other people on cymbalta – they had the same crazy effects I did! Its a tough medication to be on)

What are you taking? I think if you aren’t happy with what you’re on and it’s been long even to see the true effects of that medication without side effects go off of it for a few weeks and than try lexapro or celexa (or any other SSRI) for a month or 2 to see if you have some of the same results as I do. I really think that the SSRIs are working the best for me by keep me calm enough to handle more stress thus not have a panic or overwhelmed attack. So it prevents further pain and fatigue. I think it also help in quieting pain. An SSRI alone probably wont stop pain completely 😦 but it does help a little. If you do find one you can tolerate, after a few months you may want to add Savella (and by than I will have a better idea of how it works and if it is recommendable.)


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