Serotonin, fibro, and depression

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Date Joined Jul 2008
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   Posted 5/7/2010 8:52 PM (GMT -6)   
I am just wondering about a theory and wondering if anyone can shed the light on it . . . does anyone know for sure or read anything about it . . .
Fibromites are often put on anti depressants to combat the fibro.  Somehow they help with nerve pain or something.  But anti depressants help increase serotonin in the brain.  So, could fibro be related to a decrease in serotonin?  And would that be why the meds help?  Could that be why depression and fibro occur together in some people?

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Date Joined Jul 2009
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   Posted 5/7/2010 10:57 PM (GMT -6)   
Hi Sue, I'm one who takes a SNRI, Savella. I've been on it since last July. I have read
that people with fibro do have lower levels of serotonin. I haven't noticed any change
in my mood since I have been taking it. I believe people with a severe serotonin deficiency
would be more prone to depression. Serotonin is only one of the neurotransmitters in our
brain. They all work together to perform all our body's function. Because we are all individual, of course our levels will vary. What works for one might not work for another.
I don't know why my rheumy chose to put me on a SNRI and not a SSRI. Fibro is sure

Hugs, Robin
Fibromyalgia, MCTD (Lupus, Scleroderma & RA) Raynaud's, Osteoporosis,
Osteoarthritis, Degenerative Disc Disease, Migraines, and Hypertension
Prescription Meds: Savella, Cyclobenzaprine, Methotrexate, Diltiazem, Boniva,
Folic Acid.  OTC Meds: Multi-vitamin. Vit, D, Vitamin B12 & calciim supplements

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Date Joined Jan 2005
Total Posts : 9090
   Posted 5/8/2010 12:07 AM (GMT -6)   
Glad you brought this up, statgeek! I looked around the net for something concrete about fibro and antidepressants since my head and typing fingers don't seem to be in sync This is from an '' page. I'll cite part of it and link you to the remainder. Good reading...



Perhaps the most useful medications for fibromyalgia are several in the antidepressant class. Antidepressants elevate the levels of certain chemicals in the brain, including serotonin and norepinephrine. Low levels of these chemicals are associated not only with depression, but also with pain and fatigue. Increasing the levels of these chemicals can reduce pain in people who have fibromyalgia. Doctors prescribe several types of antidepressants for people with fibromyalgia.

Tricyclic Antidepressants

When taken at bedtime in dosages lower than those used to treat depression, tricyclic antidepressants can help promote restorative sleep in people with fibromyalgia. They also can relax painful muscles and heighten the effects of the body's natural pain-killing substances called endorphins.

Tricyclic antidepressants have been around for almost half a century. Some examples of tricyclic medications used to treat fibromyalgia include:

* amitriptyline
* cyclobenzaprine
* doxepin
* nortriptyline

Selective Serotonin Reuptake Inhibitors (SSRIs)

If a tricyclic antidepressant fails to bring relief, doctors sometimes prescribe a newer type of antidepressant called a SSRI. As with tricyclics, doctors usually prescribe these for people with fibromyalgia in lower dosages than are used to treat depression. By promoting the release of serotonin, these drugs may reduce fatigue and some other symptoms associated with fibromyalgia. The group of SSRIs includes:

* fluoxetine
* paroxetine
* sertraline

SSRIs may be prescribed along with a tricyclic antidepressant. Doctors rarely prescribe SSRIs alone. Because they make people feel more energetic, they also interfere with sleep, which often is already a problem for people with fibromyalgia.

Cymbalta (duloxetine) is a selective serotonin and norepinephrine reuptake inhibitor (SSNRI) that is also showing promise.

Mixed Reuptake Inhibitors

Some newer antidepressants raise levels of both serotonin and norepinephrine, and are therefore called mixed reuptake inhibitors. Examples of these drugs include:

* venlafaxine
* nefazodone

Researchers are actively studying the efficacy of these drugs in treating fibromyalgia.


Benzodiazepines help some people with fibromyalgia by relaxing tense, painful muscles and stabilizing the erratic brain waves that can interfere with deep sleep. Benzodiazepines also can relieve the symptoms of restless legs syndrome, which is common among people with fibromyalgia. Restless legs syndrome is characterized by unpleasant sensations in the legs as well as twitching, particularly at night. Because of the potential for addiction, doctors usually prescribe benzodiazepines only for people who have not responded to other therapies. Benzodiazepines include:

* clonazepam
* diazepam
* triazolam
* temazepam"
Gravitation is not responsible for people falling in love.
Albert Einstein

(> <) Co-Moderator Fibromyalgia & Chronic Pain Forums
Fibromyalgia, PTSD, UC, Diabetic on insulin, collapsed disk, arthritis scattered around and a few other delights.

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Date Joined Jul 2008
Total Posts : 1495
   Posted 5/8/2010 11:23 AM (GMT -6)   
Thanks Chutz, That is a big help. I have taken effexor for depression before, but it made me feel terrible, especially if I forgot it. We fibromites do forget things a lot. So I got off of it with a lot of work. I have been very depressed lately and having more pain, too.

I have been needing extra back up medicine lately. I dropped my little pillbox in the grocery store parking lot and all my extra pain meds fell on the ground! I have not filled it back up, so have been supplementing with Advil which I keep in my desk at work.

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Date Joined Apr 2004
Total Posts : 6056
   Posted 5/8/2010 2:16 PM (GMT -6)   
We have several posts discussing the links between serotonin and fibro. Serotonin is used in the brain for circadian cycles, pain awareness, mood regulation and a bunch of other stuff I've forgotten. Fibros burn thru serotonin faster than others, but no one knows why. This is why SSRI meds and others are so often prescribed. It's not just for the antidepressant action, it's to raise serotonin levels.

My doc thinks this is why so many fibros have Seasonal Affected Disorder because the lack of sunlight is linked to depleted serotonin levels. As a diabetic I've learned that pasta and rice can put me directly to sleep and this also is directly linked to serotonin levels. Doc explained to me that one of the reasons that I feel so good on vacation is not just because I get rested up. She said it's because of the increased amount of sunlight I'm exposed to (we camp) and the increase in snack foods that are starchy. (I know, naughty, naughty for a diabetic nono but a girl's gotta be bad sometimes. )

So I say we all just pack up, move to Hawaii and lay around on the beach eating starchy, high carb snack foods... tongue Then we will all feel better! And if we don't at least we will be in a pretty place where our allergies won't bother us!
~ Jeannie
Moderator for Fibromyalgia and Diabetes

Veteran Member

Date Joined Nov 2008
Total Posts : 2854
   Posted 5/8/2010 3:08 PM (GMT -6)   
Hi Sue...I was put on an SSRI for pain also, took it for three years and decided to go off it because it had such a mind numbing effect on me, plus I never noticed much difference in my pain.  However I did not wean properly and really suffered!  They are helpful for some...not so much for others.  I have just started taking Omega 3 capsules to see if they help with pain and depression...can't hurt, I guess!
fibro, menieres disease, RLS, anxiety disorder, disc compression, scoliosis, spinal stenosis TMJ  Meds: valium Advil

Forum Moderator

Date Joined Apr 2005
Total Posts : 17059
   Posted 5/8/2010 5:11 PM (GMT -6)   
I've never really suffered much with depression but, when I moved to Florida from Cleveland, Ohio, I was noticibly happier!  I didn't realize I was suffering from SAD but I must have been.  I'm now trying to get my daughter, that still lives in Cleveland, to use a light box.  She does suffer from depression.
Forum Moderator/ Fibromyalgia
Fibromyalgia, Crohn's Disease, Ostomy, Diabetes, Autoimmune Inner Ear Disease, Osteoporosis
God does not give us a spirit of fear, but of power and of love and of a sound mind.    2 Timothy 1:7

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