What You Need to Know About Fibromyalgia Medications

Learn about the different types of medicines that can be used for fibromyalgia symptoms, including SNRIs and SSRIs.

closeup shot of a pair of hands of a middle aged person selecting a pill from a pillbox

Medically reviewed in June 2022

Updated on June 29, 2022

You may already be intimately familiar with the trial-and-error process involved in finding medications that help relieve your fibromyalgia symptoms. There are dozens of medicines you could try.

It’s important to take a strategic approach by working closely with a healthcare provider (HCP) so you can monitor, modify, and fine-tune your fibromyalgia treatment program. Here are some of the medications they may prescribe to address some of the issues related to fibromyalgia.

Fibromyalgia pain
Several classes of medications may reduce fibromyalgia pain, including over-the-counter (OTC) pain relievers like acetaminophen, aspirin, and ibuprofen. If OTC products don't provide relief, prescription antidepressants and anticonvulsants may help. These include:

  • Duloxetine (Cymbalta), an antidepressant
  • Pregabalin (Lyrica), a nerve pain medication
  • Gabapentin (Neuraptine), an anticonvulsant

Fibromyalgia sleep problems
Pain medications may also help with sleep problems, but not always. If you're having trouble sleeping, ask your HCP about adjusting your current fibromyalgia drug regime. You can also ask about the risks and benefits of adding an OTC sleep aid or a stronger prescription sleep aid such as a muscle relaxant or central nervous system depressant.

Medicines your HCP may prescribe to help with sleep issues include:

  • Amitriptyline (Elavil), an antidepressant
  • Diphenhydramine (Benadryl), an antihistamine that can make you sleepy
  • Melatonin, a version of a naturally occurring hormone that plays a role in sleep

Fibromyalgia anxiety and depression
Not surprisingly, anxiety and depression often accompany fibromyalgia. There are several classes of medications that may help with depression and pain, such as tricyclic antidepressants, serotonin and norepinephrine reuptake inhibitors (SNRIs), and selective serotonin reuptake inhibitors (SSRIs). Studies show that these medications can help with major depressive disorder, which may manifest in fibromyalgia patients as symptoms such as chronic fatigue, tiredness, and decreased energy. Prescription options include:

  • Duloxetine (Cymbalta)
  • Milnacipran (Savella)

Ask your HCP which option might be best for your symptoms.

Combine medications with exercise for additional benefit
It might seem counterintuitive to go for a walk or hit the gym when you’re in pain, but some studies show that exercise can help improve physical function while alleviating pain, helping with depression and anxiety, and improving sleep quality.

Speak with your HCP about how developing an exercise regime can supplement your prescription plan and help treat your fibromyalgia for overall wellness.

Article sources open article sources

Farag HM, Yunusa I, Goswami H, et al. Comparison of Amitriptyline and US Food and Drug Administration-Approved Treatments for Fibromyalgia: A Systematic Review and Network Meta-analysis. JAMA Netw Open. 2022 May 2;5(5):e2212939.
McDonagh MS, Selph SS, Buckley DI, et al. Nonopioid Pharmacologic Treatments for Chronic Pain [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2020 Apr. Report No.: 20-EHC010.
Carmassi C, Ciapparelli A, Cappelli A, et al. Naturalistic 6-month antidepressants follow-up in patients with fibromyalgia: impact on somatic and mood spectrum symptoms. Clin Exp Rheumatol. 2021 May-Jun;39 Suppl 130(3):33-38.
McDonagh MS, Selph SS, Buckley DI, et al. Nonopioid Pharmacologic Treatments for Chronic Pain [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2020 Apr. Report No.: 20-EHC010.
Serrat M, Almirall M, Musté M, et al. Effectiveness of a Multicomponent Treatment for Fibromyalgia Based on Pain Neuroscience Education, Exercise Therapy, Psychological Support, and Nature Exposure (NAT-FM): A Pragmatic Randomized Controlled Trial. J Clin Med. 2020;9(10):3348. Published 2020 Oct 18.
Estévez-López F, Maestre-Cascales C, Russell D, Álvarez-Gallardo IC, Rodriguez-Ayllon M, Hughes CM, Davison GW, Sañudo B, McVeigh JG. Effectiveness of Exercise on Fatigue and Sleep Quality in Fibromyalgia: A Systematic Review and Meta-analysis of Randomized Trials. Arch Phys Med Rehabil. 2021 Apr;102(4):752-761.

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