fibromyalgia and neurontin

Fibromyalgia is a form of soft tissue rheumatism.

It is among the most common problems encountered by rheumatologists in practice. The disorder is felt to be due to abnormal neurotransmitter function in the brain leading to hypersensensitization to the processing of external stimuli. What that means is that fibromyalgia patients “feel” environmental stimuli more acutely than normal. This leads to a whole host of symptoms including chronic pain, sleep disturbance, short term memory problems, bowel and bladder dysfunction, to name a few.

There is no specific diagnostic test for this disease. As a result there are many physicians who do not believe in the existence of FM. Essentially what they are saying is this… “If I can’t see it, it doesn’t exist.” My personal feeling is that kind of attitude is narrow-minded thinking.

Treatment of fibromyalgia typically engages a comprehensive approach, combining exercise, medication, and physical therapy.

Many medications are used to help correct neural pathway abnormalities. Dopamine, serontonin, nor-epinephrine, and GABA seem to be the major paths affected by FM.

NIAMS, the National Institute of Arthritis and Musculoskeletal and Skin Diseases, is funding a study which will assess the effectiveness of gabapentin in reducing the symptoms of fibromyalgia syndrome (FMS). Gabapentin, which is the generic form of Neurontin, is an anticonvulsant medication. The drug has also been found to relieve chronic pain caused by nervous system disorders, and was most recently approved by the FDA for the treatment of persistent, severe pain associated with shingles.

Currently no medications are specifically approved by the FDA for the treatment of fibromyalgia. To treat the symptoms of FMS, many people are prescribed:

• nonsteroidal anti-inflammatory drugs (NSAIDS)
• muscle relaxants
• antidepressants

Depending on the study results, gabapentin may become another treatment option for the estimated 3 to 6 million Americans affected by FMS. Mostly seen in women, FMS can affect children and men as well.

Approximately 150 study participants with FMS will be randomly assigned to take either gabapentin or a placebo for a 12-week period. The effectiveness of the medication will be evaluated using questionnaires that assess:

• fatigue
• stiffness
• sleep
• mood
• tender point pain threshold
• quality of life

Tender points are specific places on the body, located on the neck, shoulders, back, hips, and upper and lower extremities, where people with FMS often feel pain in response to slight pressure.

NEURONTIN (new-RON-tin), also called gabapentin, is a prescription medicine that can be used to treat nerve pain that follows shingles in adults.

Do not take NEURONTIN if you are allergic to gabapentin, the main ingredient in NEURONTIN, or any other ingredient in NEURONTIN

Take NEURONTIN exactly as prescribed by your doctor. Your doctor will tell you how much to take and when to take it. Your doctor may start you on a low dose and gradually increase the dose over days to weeks. It may take days to weeks to know NEURONTIN is working. If you are over 65 years old or have kidney problems, your doctor may give you a lower dose of NEURONTIN.

NEURONTIN comes in:
Capsules - 100 mg, 300 mg, and 400 mg
Tablets - 600 mg and 800 mg
Liquid - 250 mg/mL (cc)

• Take NEURONTIN at the same time each day. If you miss a dose, take it as soon as you remember. If it is close to your next dose, just take your regular dose. Do not take more than 1 dose of NEURONTIN at a time.
• You can take NEURONTIN with or without food.
• If you take antacids such as Tums®, or Maalox®, wait 2 hours before taking NEURONTIN.
• Do not stop taking NEURONTIN unless your doctor tells you. Stopping NEURONTIN suddenly may bring on a seizure. Your doctor will tell you when and how to stop taking NEURONTIN. Follow your doctor’s directions. The dose will be decreased slowly, over a week or more.
• Do not run out of NEURONTIN. Plan ahead to have a refill on hand.
• If you take too much NEURONTIN or overdose, call your doctor or poison control center or go to the nearest emergency room right away.

Do not drive a car or operate heavy machinery until you are sure you can stay alert while taking NEURONTIN. NEURONTIN may make you sleepy or dizzy after taking it.

Some people may have side effects while taking NEURONTIN. Side effects are usually mild to moderate in severity. The most common side effects in patients with nerve pain are

• Dizziness
• Vision problems
• Clumsiness
• Sleepiness, tiredness
• Shaking or tremor
• Swelling of hands or feet
• Weakness
• Diarrhea

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Fibromyalgia and neurontin