Choosing Tricyclic Anti-depressants In The Treatment Of Fibromyalgia

In addition to the use of anti-depressants for treating depression, they have also become a common choice of medication for fibromyalgia sufferers. This doesn't suggest that fibromyalgia isn't a physical medical condition. Studies have shown that tricyclic anti-depressants taken in a dose lower than needed to treat depression, can be very helpful with sleep problems and pain relief. Tricyclic anti-depressants are not new and have been in use for a long time. The most common tricyclic drugs used to treat fibromyalgia are amitriptyline, cyclobenzaprine, doxepin and nortriptyline.

How Do Tricyclic Anti-depressants Work?

It is not known exactly how tricyclic anti-depressants work to improve fibromyalgia symptoms. It is thought that they elevate the level of specific chemicals in the brain including serotonin and norepinephrine. This can help with pain management and promote restorative sleep.

What Are The Benefits?

The anti-depressants have proven to be beneficial in relaxing painful muscles. Chronic pain is a major symptom of fibromyalgia and it impacts on every day life. Sufferers find that the muscular pain affects sleep and can lead to depression. Endorphins are the natural pain-killing substance that the body emits. Tricyclic anti-depressants enhance these endorphins and can reduce pain levels. For some fibromyalgia sufferers, the drugs help them to have a less fitful sleep at night by increasing the deep phase of sleep and reducing the occurrence of muscle spasms.

What Are The Side Effects?

As with all medications, there are side effects with tricyclic anti-depressants. These side effects vary among the specific medications but the following is a general list of potential side effects:



-Dry mouth


-Fast heart rate

-Blurred vision

-Difficulty urinating

People with glaucoma, epilepsy, heart conditions or urinary retention may find that the anti-depressants make the symptoms worse. However, tolerance to these negative effects is often developed if the treatment is continued for a longer period of time.


Doctors do not automatically prescribe tricyclic anti-depressants for fibromyalgia sufferers. They tend to use them for patients who have sleep problems as one of their major symptoms. The medication is not intended to work as an anti-depressant and if the patient is also suffering from depression, a higher dosage needs to be given.

Some studies have shown that tricyclic antidepressants combined with a selective serotonin reuptake inhibitor such as Prozac, provide the most effective treatment for sleep problems and chronic pain. Current research shows that the tricyclic groups of anti-depressants are more effective than other anti-depressants in fibromyalgia treatment. However the benefits have shown to be less effective over time.

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