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I read both of your posts and I recall responding to a much earlier post. I suggested that you try contacting the National Fibromyalgia Association website for a referral to a fibro-friendly doctor in your area. I hope that the doctor that you are seeing now is not that person. If so, you need to go back to them and ask that he be removed from the list.
First of all, amitriptyline is commonly prescribed for fibromyalgia (FMS) sleep issues. FMS interrupts the deep sleep (REM) cycle. IF you do not get that restorative sleep, than your muscles will not recover from the previous days activities which results in pain. The less restortative sleep you get, the higher the pain level. While I can understand why your doctor is so adamant about getting restorative sleep, perhaps Amitriptyline is not the answer for you.
You may need another sleep medication that is more effective in your case.
FMS pain can be managed but it is never going to completely go away. You have to learn to live with it which means learning to pace yourself and saying "no" to activities that will push you past your limits. There will be decent days, the rare good day and a fair amount of bad to terrible days. Some people see a counselor to learn better coping skills through cognitive therapy.
A roller coaster with extreme highs and lows is a very good analogy.
Your doctor is absolutely correct in saying that narcotics typically do not work for FMS pain. Only certain classes of medication work and they are usually anti depressants that must be prescribed. It is not understood why so few drugs respond to the pain of FMS at this time. If someone could figure out the mechanism that triggers it, we'd all be in a better place. I fail to understand his reasoning behind refusing to prescribe Lryica. It is not an antidepressant but it is especially formulated for FMS. However, most users have a problem with significant weight gain and or swelling of hands and feet. I opted to stay away from it for those reasons alone. People that use it have mixed reactions, but most report some relief and feel that is a trade off for the other side effects like weight gain etc.
Cymbalta (anti depressant) is another popular choice for FMS. It addresses both the chronic pain and depression isssues associated with FMS. I take it myself (30 mg)and find it very helpful. Many people on this board have had pretty good success with Cymbalta. The standard dose seems to be 30 - 60mg for FMS. I have had no issues with it other than feeling a bit foggy for a week or so. Like any new medication, it takes time to get into your system (at LEAST two weeks) and for you to get used to it.
It takes quite a bit of time and tinkering to find the right combination of drugs that are effective for each FMS person. You definitely need to find another doctor who is fibro-friendly and a bit more open to using other medication.
Narcotics should be the absolute last resort as there are many other things that can be tried first. Lately it seems that we have had a high number of people insisting that they need narcotics on this board. Just like you, most of them have been mismanaged by medical professionals. I hope that you are able to find someone in your area with a better understanding of FMS and current drug therapy. Keep in touch and let us know how you are doing. Take care.
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