Treating your fibromyalgia syndrome is an ongoing and sometimes frustrating process. There are so many different treatments available that it can be overwhelming trying to select the right one for you. Often, medications to relieve fibromyalgia symptoms cause unwanted side effects that are even worse than the pain itself. If you are having trouble finding an effective fibromyalgia medication, you may be interested in trying transdermal medications. These act fast to relieve stiff and aching muscles but cause fewer side effects than other types of medications.
Transdermal medications work differently than most other fibromyalgia medications. Instead of being taken orally, transdermal medications are applied to the skin. Over time, these medications penetrate the skin and enter the bloodstream, providing fast and long-lasting relief.
There are a variety of different types of transdermal medications. You are probably already familiar with topical transdermal medications, simply referred to as “topicals”. These consist of creams, gels, and ointments that you apply to different areas of your skin. Topicals are available in both over-the-counter and prescription forms. The patch is a newer form of transdermal medication. Introduced in 1980, the patch works just like topicals – by releasing a steady stream of medicine into the body via the skin. Instead of coming in cream form though, these medicines are worn as a patch on the body.
How Transdermal Medications Work
Transdermal medications are all based on the same premise: they use the skin as a way of entering the body. The skin is actually your body’s largest organ. It is responsible for performing a variety of tasks to keep you healthy, including regulating body temperature and controlling fluid loss. The skin consists of many layers, which are interconnected by a network of blood vessels. As transdermal medications penetrate the skin, they slowly enter the bloodstream, providing steady relief of pain symptoms.
Transdermal medications also work by operating on nerve endings in your skin. Your skin is covered in miniscule nerve endings, which receive a variety of different messages about the environment around you. These nerve endings often receive pain messages, which are then sent to your spinal cord where they are amplified. Transdermal pain medications prevent these nerve endings from picking up on such pain signals.
Advantages of Transdermal Medications
Transdermal medications are rapidly becoming popular among fibromyalgia sufferers. This is because they offer numerous advantages that oral medications do not. Benefits of transdermals include:
- ease of application
- longer-lasting pain relief
- fewer side effects
Types of Transdermal Medications for Fibromyalgia Patients
Topicals have long been used to treat fibromyalgia pain, but they are often overlooked as genuine pain medications. Here are some topicals to ask your health care provider about.
Zonalon Cream (5% Doxepin)
Zonalon cream contains the medication doxepin, which is a tricyclic antidepressant. It works to relieve pain by blocking sodium channels and NMDA receptors that are involved in sending and receiving pain messages. Zonalon cream also stimulates your body’s natural opioid receptors, enhancing pain relief. Studies show that fibromyalgia patients who used Zonalon cream experienced significant relief of muscle pain. Zonalon cream takes about 3 weeks to become effective. It can be applied up to 4 times a day. Side effects include: dry mouth, skin rash, headache, nausea, and drowsiness.
Menthol is often used in over-the-counter topical medications. Menthols works to block by pain by activating kappa opioid receptors in your body, providing natural pain relief. When applied, menthol creates a cool, tingling sensation, soothing the affected area. After a while, the menthol begins to warm up, providing relief from stiff muscles. When used over time, menthol actually increases your pain threshold. Possible medication side effects may include allergy and skin inflammation.
Transdermal patches are relatively new to the medical world, but they have taken off in the past few years. They are less messy than topicals but provide the same pain relief. Here are some popular patches for fibromyalgia.
The fentanyl patch, sold under the name Duragesic, is used to provide pain relief for up to 72 hours. It is an opioid pain relief medication and therefore recommended for use in those peole already using opiods therapy and have shown opiod tolerance. Fentanyl binds to receptors in the body encouraging pain relief. The patch takes about 12 hours to work, as the drug must build up in the bloodstream before it becomes effective. However, it can be worn safely for up to 72 hours. The fentanyl patch causes fewer side effects than oral opioids because it bypasses the stomach, eliminating nausea, constipation, and diarrhea. Possible side effects may include: dizziness, lightheadedness, weakness, and shortness of breath.
Gabapentin and Fibromyalgia
A recent study found that Gabapentin was effective in alleviating common fibromyalgia symptoms, and some experts are hopeful that the drug may soon become a fibromyalgia pain relief medication.
The study included 150 participants, 90% of whom were women (there is a higher rate of incidence of fibromyalgia in women compared to in men). The study randomly assigned dosages of Gabapentin or placebo to participants for a 12-week period. The effectiveness of the drug was based on the following categories:
Gabapentin was generally well tolerated; side effects of gabapentin were reported, the most common of these being dizziness or sedation. However, these symptoms were generally mild to moderate in nature.
According to the study, Gabapentin helps to minimize fibromyalgia pain by binding to a specific subunit of voltage-gated calcium channels found in the nerves; this helps to reduce the calcium flow to the nerve cells, which in turn minimizes the release of signaling molecules that are central to the pain process in the body. This finding is in line with one of the theories behind the causes of fibromyalgia, namely, that fibromyalgia is caused by an abnormality of the pain processing in the nervous system.
One of the most frustrating symptoms associated with fibromyalgia is disturbed sleep. Many fibromyalgia sufferers find that they have trouble falling asleep and staying asleep. As a result, many fibromyalgia patients look to medications to improve their sleep habits. While not necessarily a permanent solution, sleep medicines can offer some relief for fibromyalgia sufferers.
What are Sleeping Medications?
Sleep medicine is specifically intended to help you sleep better at night. These medications may enable you to fall asleep faster, stay asleep longer, or feel more rested when you wake up. Sleeping pills are often referred to as sedatives because they sedate your brain and your body, allowing you to relax and fall asleep. There are numerous different types of sleeping pills. Some work for a long time in the body (these are referred to as long-acting sleeping pills) while others work for a shorter time (these are called short acting sleeping pills).
The Controversy: Why Prescribe Sleeping Pills?
There is a lot of controversy over the prescription of sleeping pills to people who have difficulties sleeping. Many sleeping pills and sedatives are habit-forming, and can lead to severe addictions. Persistent or long-term use of sleeping pills can cause your body extreme damage and can lead to devastating withdrawal symptoms, including hallucinations, delusions, and tremors. For these reasons, many health care providers refuse to prescribe sleeping pills to some patients. Moreover, sleeping pills can eventually make sleep patterns even worse, disrupting the natural rhythm of the body.
However, sleeping pills can be very beneficial to people who have a known cause for their sleeping problems. If the cause of insomnia can be treated, sleeping pills may offer temporary relief of symptoms, allowing you to get some sleep. However, sleeping pills should not be used for more than 4 weeks at a time to avoid dependency.
How do Sleeping Pills Help Fibromyalgia?
Many fibromyalgia patients suffer from debilitating sleep disorders, including insomnia, nighttime waking, and non-restorative sleep. In fact, 90% of fibromyalgia sufferers report that their sleeplessness is debilitating. The short-term use of sleep aid medication allows many people with fibromyalgia to take control of their sleep patterns and begin to get some rest. Additionally, prescription sleep medication often helps to reduce the intensity of muscle pain and spasms that comes along with fibromyalgia, making life more enjoyable.
Types of Prescription Sleep Medicine
There are a number of different types of sleeping pills, including new sleep medications, which are available for use. Every type of sleep inducing medication is associated with different efficacy rates and side effects, so please consult with your health care provider before choosing a sleeping pill.
Benzodiazepines are a class of drug that have been available since the 1960s. They are commonly prescribed as both sedatives and pain relievers. Benzodiazepines work to calm brain activity down by working on a special neurotransmitter in the brain, called GABA. GABA is a chemical responsible for helping to sedate brain activity. Benzodiazepines actually increase the amount of GABA in the brain, allowing you to sleep, rest, or feel less pain or anxiety. Benzodiazepines have been proven to decrease the time needed to fall asleep and increase the time spent in deep, restorative sleep.
There are a number of different kinds of benzodiazepines, including temazepam, loprazolam, and nitrazepam. To help with insomnia and other sleep disorders, shorter acting benzodiazepines are usually used, as they are less likely to cause dependence. The most commonly prescribed benzodiazepine for fibromyalgia sleep disorders is temazepam, which goes by the brand name Restoril. Side effects include: depression, headache, sleep disturbance, dizziness, and weakness. To minimize side effects and the likelihood of dependence, benzodiazepines should only be taken for a maximum of four weeks.
Imidazopyridines are newer sleep medicines than benzodiazepines, but they act on the same GABA receptors in your brain. Because they are short acting, imidazopyridines are less likely to cause addiction or tolerance, and therefore are being prescribed at increasing rates. The most common imidazopyridines include zolpidem, zopiclone, and zalepon. Like benzodiazepines, imidazopyridines should only be taken on a short-term basis. Side effects include: addiction, distension, nausea, vertigo, dizziness, nightmares, and skin rash.
Barbiturates are prescription sleep medications that work by suppressing activity in your central nervous system. They also help to inhibit nerve and muscle activity, thereby limiting pain. There are numerous barbiturates available on the American market, including: Phenobarbital, amobarbital, and butabarbital. However, barbiturates are not commonly prescribed for people with fibromyalgia because of the likelihood of addiction. Barbiturates also cause a number of side effects including: fever, sore throat, chest pain, wheezing, skin problems swollen eyelids and face, and muscle and joint pain.
Antihistamines are usually used to help relieve allergy and cold symptoms, however, they can also be used as sleeping aids because of the drowsiness they cause. Antihistamines are available as over-the-counter sleep medications, and include diphenhydramine and promethazine. Antihistamines should only be used on a short-term basis because they can cause side effects including: dizziness, headache, blurred vision, dry mouth, confusion, and excitement. Antihistamines are often used to promote sleep in the elderly.