Diagnosis: Wake and Ache

Pills for a puzzling illness. The answer to treating fibromyalgia.

By Clayton Simmons, published on May 1, 2009 - last reviewed on June 9, 2016

Fibromyalgia is a mysterious disorder that afflicts up to 12 million Americans, mostly women. Patients who have it report terrible pain throughout the body, but doctors can't find anything physically wrong.

A research meta-analysis, however, suggests that fibromyalgia pain may be treatable using antidepressants. Some doctors suggest that the disorder stems from depression, but these results seem to counter that argument, since antidepressants soothe fibromyalgia pain even at lower doses than those required to treat depression. And the neurological pathways antidepressants affect in fibromyalgia are distinct from those by which they lift spirits, lead author Winfried Haeuser says.

The paper found that tricyclics reduced pain, fatigue, and sleep disturbances; to a lesser extent, SSRIs and MAOIs reduced pain and SNRIsreduced pain and improved mood and sleep.—Clayton Simmons

Soothing Behaviors

Nondrug treatments are essential to battling fibromyalgia.

  • Exercise and educate. Fibromyalgia experts suggest combining regular aerobic exercise with cognitive-behavioral therapy.
  • Try alternatives. Other treatment options are less clear-cut: acupuncture, hypnosis, reflexology, or massage therapy. Studies show inconsistent results.
  • Do it all. The most effective treatment plan, many physicians say, employs many approaches in tandem—drug therapy along with psychotherapy, exercise, and good sleep.