Fibromyalgia Therapy: Marijuana Vs Antidepressants and Opiates

(PORTLAND, OR) - Fibromyalgia is not only a very mysterious disease, but the therapy is even far more confusing. Nobody seems to know exactly what causes it and if one does not know what is the mechanism, how can one treat it? Severe generalized pain is the principle symptom but strong painkillers are not the answer and many physicians have been severely punished by medical boards for giving patients good pain relief.

One leading physician in Portland, Oregon, decided that clinical depression caused the pain, therefore a new class of antidepressant drugs, principally Elavil, or Amitryptiline, should work. It made the patients so mentally dopey that it reduced their pain.

His theory was that clinical depression caused the pain, actually it was the other way around ----- PAIN CAUSES DEPRESSION! He subsequently wrecked several hundred patients with this drug before he retired.

Other drugs which had been tried early were Flexeril, Gabapentin, which like Elavil, made patients feel dopey or stupid and was not acceptable to most patients.

At the time I wrote about the various medications tried, which were; anti-inflammatories, strong painkillers, muscle relaxants, antidepressants, anti-seizure meds, sleeping pills, Aderal and non-pharmaceuticals, acupuncture, walking exercise, recuperation (?), low carb diet, physical therapy and massage. None of these helped much.

During this time, Charlotte Rayner, a Yahoo contributor, wrote 'Fibromyalgia - Cause, Symptoms, Diagnoses and Treatment', which essentially covered none of the subjects of the title, but her suggestions for treatment were off the wall. She does falsely quote me in her second and third paragraphs, but doesn't mention cannabis/marijuana anyplace.

Her list of suggestions for successful treatment are really confusing, she advocates lifestyle alterations (?), over the counter pain medications (laughable), non-narcotic pain medications (more laughable), low dose antidepressants (even more laughable), injections of Lidocaine (act for a few hours), gentle exercise (very painful), sleep medications (only strong ones work), emotional and psychological support (patients ask, give me some relief!), massage therapy, water therapy, physical therapy, relaxation therapy, aroma therapy, light aerobics, nutritional supplements, chiropractic and osteopathic manipulation. Obviously she never talked to any patient with Fibromyalgia who would consider her off her rocker.

My medical marijuana patients told me that marijuana worked better than any other medication. I ended up with about 500 Fibromyalgia, or about 10% of my 5000 patients, who had been prescribed a disturbing amount of different medications.

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grammaruff March 11, 2013 11:12 am (Pacific time)

The underlying cause of all these pain diseases is the daily exposure to toxic chemicals. Why isn't somebody talking about THAT???

Gerry March 3, 2013 1:22 pm (Pacific time)

I was diagnosed with fibromyalgia a few years ago. He gave me Lyrica, didn't help just made me more constipated and it messed with me sexually, (no desire) so they put me on Vicodin, helps some but I'm still constipated and a zombie part of the day , I also have degenerative disc, bone and tendon disease. I use med mj and it does help. I used to exercise daily but now my feet are so bad I can't walk 50 feet without them throbbing. There is nothing I have found that really alleviates the pain, my sleep is completely disturbed from the pain.Sometimes I'm up for 2 or 3 hours during the night and up several times. It's a vicious cycle if you don't get good rest you can't heal from the days wear and tear, but if you hurt so bad that you can't sleep you won't heal either. My biggest problem is the tendons in my hands and feet, and I have restless leg syndrome. alot of the RLS is from the pain, and some from when I eat too much sugar. I am not depressed as most fibromyalgia patients are. I will not allow depression to be a part of my life. But it is hard to maintain an upbeat attitude when you hurt all the time. I don't know what the solution is, I've never tried the simpson oil, it is not easy to aquire around here. If anybody has any other suggestions I'm open for anything that will help me not hurt so much. I'm only 61 I should not feel like this all the time.

Shay Nielsen March 3, 2013 8:42 am (Pacific time)

I was disturbed by the gross misinterpretation of the facts of how and why certain medications such as Elavil and Gabapentin are used. The fact that this is written by a PhD Professor of Pharmacology disturbs me even more. The neurological pathways blocked by these medications also assist in blocking the transmission of pain signals. Gabapentin has been used successfully in treating generalized pain especially those related to nerve damage including neruopathy from Multiple Sclerosis, diabetes and chemotherapy. Lyrica has been moderately successful in treating certain patients with fibromyalgia. The current accepted theory of the "cause" of fibro is the misfiring of pain receptors and nerves in the deep muscle tissue and fascia. Massage as preformed by a trained massage therapist has been proven to help reduce pain and promoted secretion of endorphins a natural pain reliever as does acupuncture.This may not make a fibro patient pain free, but as part of a MULTIDISCIPLINARY approach can assist in reducing pain. Now, medical marijuana and use of THC has shown in preliminary studies to help assist with generalized pain. More double-blind studies are needed to adequately assess the ability of marijuana to do so. Also, more methods for consistency in dosing need to be developed to be able to adequately study medical marijuana. ADDITIONALLY generalized pain is one of many cardinal symptoms of depression whereas the depression causes the pain and then the pain exacerbates the depression creating a negative feedback loop. Hence, the use of certain antidepressants such as Cymbalta are now APPROVED BY THE FDA to treat generalized pain, osteoarthritis pain and chronic low back. I find it disturbing that an Associate's Degree prepared nurse can craft a more intelligent, thoughtful and factual argument than a PhD prepared PROFESSOR of Pharmacology.

The purpose of antidepressant use to treat pain is NOT to make a person so mentally dopey that they do not feel pain. The purpose is to block pain transmission. Unfortunately blocking these receptors can have the side effect of casing a patient to feel mentally sluggish. Use of marijuana can and does produce the same effects. The kids call it "getting high".

Please don't get your information from NIDA (National Institute of Drug Abuse) Read some of my articles. I have tried Elavil and Gabapentin - I wouldn't prescribe them to my worst enemy. Multiple disciplinary approach has been a consistent ongoing failure.

Dr. Phil Leveque

Pratik March 2, 2013 4:38 pm (Pacific time)

This theory is only partially correct. the author of this article should do their homework, depression and fibromyalgia are linked but is not the only source of how pain is developed and permeates through the body. I had a spinal injury ( disc herniation) and post surgery my pain was exacerbated and spread throughout my body. I'm a male, putting me in even smaller company of fibromyalgia ( complex pain disorder ) patients.

Are you a physician with more than 65 years of experience? I resent your condescending attitude, nobody will listen because you insult our writer, I know I'm not, have some respect or just don't bother next time.

The Girl in Yoga Pants March 1, 2013 9:22 pm (Pacific time)

"Light aerobics" - HAAAA!!! I pushed myself through FIVE MINUTES of "light aerobics" last week. It took two days for the soreness to set in and another 5 days to recover. She's retarded.

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Fibromyalgia Therapy: Marijuana Vs Antidepressants and Opiates

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