Simple analgesics, such as paracetamol, and mild opiates, such as codeine and the atypical opiate Tramadol, are recommended for the treatment of pain in Fibro patients13 33.
Research has suggested that opioid medications do not work as efficiently in Fibro patients as in healthy people because of a lack of available opioid receptors in the brain of Fibro patients19. According to the EULAR Guidelines for the Management of Fibro, strong opioids - e.g. morphine - are not recommended for Fibro33. If a doctor is unwilling to prescribe strong opioids for a Fibro patient, it is not necessarily because they do not believe that the patient is in pain: probably more that they are unsure that the side effects and risk of addiction with strong opioids are worth it when they do not work very efficiently and other forms of medication may work better.
Acupan (Nefopam Hydrochloride) is a non-opioid analgesic that is used for both the fast treatment of acute pain and the treatment of constant, chronic pain. How Acupan works is not well understood, but inhibition of serotonin, dopamine and noradrenaline reuptake is thought to be involved. It is of particular interest for the treatment of Fibro because of its effects on dopamine.
Non-steroidal Anti-Inflammatory Drugs (NSAIDs), such as Ibuprofen, are sometimes used as mild analgesics in the treatment of Fibro. However, Fibro itself does not have inflammation associated with it and so the anti-inflammatory benefit of NSAIDs is wasted. NSAIDs also carry a risk of gastrointestinal complications and Fibro patients are already at higher than normal risk of suffering from gastrointestinal conditions, such as Irritable Bowel Syndrome (IBS) and reflux.13
Other medications can have pain relieving effects and may be used in the treatment of Fibro.
Next: Sleep Medications
References