SSRI's may be your best bet, I have been on the same dosage for years without any tolerance issues. You need to totally understand the condition--poor sleep will only help increase your pain. Improve your sleep, and your pain will be more managable. For years, an SSRI was all I took. A couple years ago, I had to add something for pain but I take it only when necessary. There are some excellent books available that are well- researched. Serotonin is the neurotransmitter thought to be responsible, usually we lack the ability to produce enough. Specific Serotonin Reuptake Inhibitors is a class of drugs most helpful for FMS/MPS. I realize doctors often prescribe different medications and I am sure, other combinations may work well. I can only attest to the success of SSRI's.