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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18458
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I have been diagnosed with fibromyalgia, some years ago. This

Resolved Question:

I have been diagnosed with fibromyalgia, some years ago. This pain is managed by Butrans patche, naproxen, paracetamol, as needed. I also take Vit D and Magnesium supplements. I have very poor sleep patterns and always feel very tired. My skin is looking very dry especially on my hands despite regular use of emollients.i try to stay active and positive, but just lately have developed an overall lethargy, feelings of panic and anxiety wash over me unexpectedly, and I feel "unwell" like flu starting, a lot of the time, and something akin to a sense of desolation.
I'm 64, married with a close, supportive family. I have financial security and to all intents a very good life.
I wonder if I have a thyroid function issue. Could this be possible? I have lost a stone and a half over 18 months without dieting, am now 9st 5 height 5' 3". Any advice?
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. D. Love replied 1 year ago.
Hello from JustAnswer. In someone with fibromyalgia associated with poor sleep pattern, lethargy, anxiety symptoms, general malaise, and a sense of desolation, it would be appropriate to consider the use of an antidepressant. Several different antidepressants have been shown to be helpful for fibromyalgia, even if there are no associated symptoms, and they also can help with anxiety/panic symptoms and the sense of desolation. The antidepressants that have been most studied in people with fibromyalgia have been amitriptyline, nortriptyline, and duloxetine, but there are several others that also can be tried. There are also certain antidepressants that are more sedating, so may be helpful in this situation, such as trazodone. Have you been tried on any of these medicines?
Customer: replied 1 year ago.
Yes, all three with Amitriptylene. Low dose as probably the most effective, though can have a sluggish morning after sensation. Just finished a two month course of Duloxetine, but didn't find it useful.
Expert:  Dr. D. Love replied 1 year ago.
What are the various medicines that you have tried?
Customer: replied 1 year ago.
Gabapetine, cortisone injections, caudal epidural, as well as above, have also take 2mg diazepam on occasion for muscle spasm and TMJD. These manage pain, but not the additional symptoms of overall "feeling unwell" this sense of unease, panic etc is fairly recent. Nothing really helps the sleep pattern, getting off to sleep ok but then waking and being awake and restless for up to a couple of hours, I never sleep all night.
Expert:  Dr. D. Love replied 1 year ago.
If these three antidepressants are the only antidepressants that have been tried, then it would be reasonable to try an antidepressant in a different chemical class and works on different neurotransmitters in the brain. The trazodone that I mentioned above is one of the more sedating antidepressants. Other antidepressants in different chemical classes include bupropion and mirtazapine.
Customer: replied 1 year ago.
Thank you I haven't heard of those. I will check with my GP and maybe have some blood tests for thyroid too. Thankyou
Expert:  Dr. D. Love replied 1 year ago.
You are very welcome.
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