04/17/09 An inexpensive, generic drug currently used to treat alcohol and drug addiction may offer relief to people who have fibromyalgia.
In a small pilot study, Stanford University researchers gave the drug naltrexone or a placebo to 10 women with a diagnosis of fibromyalgia over 14 weeks.
By the end of the study, participants reported 30 percent greater improvement in their fibromyalgia symptoms when they took the naltrexone compared how they felt when they were taking the placebo.
Jarred Younger, PhD, an instructor of anesthesia and pain management at the Stanford University School of Medicine in Palo Alto, Calif., who was the lead researcher on the study, admits that the decision to try naltrexone for fibromyalgia appears, at first blush, to be counterintuitive.
That’s because naltrexone, a drug that has been used for 30 years to treat alcohol and drug addiction, works by blocking the affects of opioids on the brain; and opioids kill pain.
But Younger says that in smaller doses, the drug may have a different effect, switching off cells called microglia.
“Microglia are normally really good cells to have,” Younger says, “They’re our brain’s immune system cells, and when they detect a virus or something they become activated, and they produce a number of chemicals that help fight off the infection, but they also produce chemicals that make us feel really sick.”
Younger’s hypothesis is that in fibromyalgia, microglia may be switched on, and stay on, even when there’s no infection to fight. “So we think fibromyalgia is an immune system disorder,” he says.
Younger says he got the idea to study naltrexone because of the successes reported by a group of doctors in New Jersey who had tried it on their patients who have the puzzling condition, which is characterized by widespread pain and fatigue.
“I’ve seen too many people with fibromyalgia who have tried everything and they don’t work, and they’re suffering,” he says. “And it’s a lot of people who are still suffering.”
Younger thinks there may be alternative treatments or off-label treatments, such as naltrexone, that work for fibromyalgia, but they wouldn’t ordinarily be studied because there isn’t enough money to be made from their development.
His pilot study, which was published in the April 17, 2009, issue of the journal Pain Medicine, was supported, in part, by a grant from the Arthritis Foundation.
For this initial investigation, researchers recruited 10 women with a clinical diagnosis of fibromyalgia and had them take 4.5 milligrams of naltrexone or a placebo daily for 14 weeks. Each participant took both the drug and the placebo, so they acted as their own control subjects, but they were not told which weeks they were taking a placebo and which weeks they were given naltrexone.
Each of the women had a hand-held computer and used it to report daily symptoms of pain, fatigue, sadness, stress, sleep quality, the ability to think and remember, gastrointestinal symptoms and headaches. Participants were also evaluated in a lab every two weeks to obtain their mechanical, heat and cold pain thresholds.
During the placebo phase of the study, symptoms were reduced an average of only 2.3 percent. During the weeks when the women were taking the naltrexone however, their symptoms improved by 32.5 percent. Their lab-tested pain tolerance also increased on naltrexone, but did not improve when they took the placebo.
Minimal side effects were reported in the study. Two participants reported experiencing vivid dreams while on the medications and one reported nausea and insomnia for a few nights that eventually went away.
The naltrexone was so beneficial for some study participants that they continued to take it and see further improvement after the study ended, Younger says.
The Stanford researchers have been so encouraged that they are currently mounting a larger, longer double-blind study to see if their first results will hold.
Find out more about fibromyalgia treatments and fibromyalgia medications.
As far as the pain goes I have two herniated discs one in my neck and one in my lower back,I was told yesterday by the surgeon that they will not operate at this time as it is to dangerous.and are blaming the fms for most of the pain only when its the last resort they will operate.
Im taking Lyrica and cymbalta, I first took cymbalta then had a break for a while but had to go back on it because I feel I am alot better with it,still have widespread pain,i also take enantyum for pain but I really don't think it works.I have to have someone to clean my house as its to much for me.and my husband is fantastic support for me.
can anyone recommend a better pain killer that wont upset my stomach, I am so lucky that I don't pay for any of my tablets I know they are very expensive and i sympathize with all you people that do have to find the money to pay for these drugs at least I haven't got that worry.I have some good news I am to be a grandma in November I am hoping this will take my mind of my problems. take care, and try to keep positive.
I'm one of the rare males with fibro and it was bad enough to force me to close my business.
Besides pain meds, best results for me have come from consistent mild exercise, especially warm water arthtitis workouts and Tai Chi, plus an occasional therapeutic massage. Of course walking and stretching. (Check your local Arthritis Foundation, local Y's, etc. for water and Tai Chi)
I have to thank a couple of very helpful doctors willing to try various approaches.
For JoP with foot problems -- See your orthopedist or a podiatrist. The pain and tingling in toes and around the ball of your foot sounds like Morton's Neuroma, which I suffer from. Nerves "bind up" between the tarsals and only relief is from cortisone/lidocane injections or surgical removal, which leaves the toes totally numb. Try cotton balls between your toes, go barefoot when possible and wear loose fitting shoes; anything that binds at all causes discomfort.
However, I've been having the symptoms you describe along with an "over the top" fibro flare with leg and back muscles in constant flex/tension. I wondered why, and thought maybe my orthotics need adjustment. I'll try that, just in case, of course.
The medication mentioned in this article sounds promising. I have had no luck with any other meds that help many folks, and really don't want to try the anti-seizure type meds till I absolutely have to.
Good luck with the feet!
quote for today
"enjoy when you can, endure what you must."
I suffer terrible pain due to a spinal cord injury, FMS, MPS , neuropathic pain and a neuromuscular condition from a mountain climbing accident where I am from out in Colorado. I am so happy we have each other for support.
Loti
I have Fibromyalgia and osteoarthritis and have had both for over 20 years.
I recently have been experiencing pain in both feet. It effects the bottom of the foot in the instep and pad below the toes(burning pain).
Effects the top of the foot in the arch and toes.
I need to excerise (I'm tired all the time and have no strength) but cannot walk far without having to sit. the pain in the feet effect the way I walk and then I have back pain. I can walk around the grocery store and Wal Mart. I've avoided using the electric carts.
What kind of excersie can I do that will help with mobility and strength building?
I see a Doctor for the arthritis and fibromyalgia and a doctor for my feet.
of us with FM--I'm turning 70 this summer and am exhausted from having this for 20 years.
Too much pain isn't good for the brain researchers and that I personally know. I get a weekly massage which lasts about 1 1/2 days; sometimes when it's about a 9 or 10 on the pain scale, I get acupuncture. I take aspirin
when the pain is around a 7. Gave up most
housework due to FM and osteo. Gave up standing to cook --huge other adjustments to
this "thing /disease?syndrome?
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