Dos nuevos fármacos aprobados por la FDA para el tratamiento de la fibromialgia

Si bien no existe una cura para la fibromialgia, la clave para encontrar alivio del dolor, la fatiga y otros síntomas suele ser una combinación de medicamentos y terapias naturales. El mejor médico para tratar la fibromialgia es un reumatólogo, un médico que se especializa en el tratamiento de la artritis y las afecciones relacionadas. Puede llevar un tiempo de prueba y error encontrar una combinación efectiva de tratamientos. Aquí hay algunas opciones que vale la pena probar:

 

Medicamentos

Actualmente, hay dos medicamentos aprobados por la FDA para su uso como tratamientos de fibromialgia: duloxetina y milnacipran.

La pregabalina  se desarrolló originalmente como un medicamento anticonvulsivo, pero desde entonces ha demostrado beneficios para aliviar la ansiedad, algunos problemas de sueño y dolor en personas con fibromialgia. Otra medicación anticonvulsivante, la gabapentina, a veces se usa como tratamiento no autorizado para la fibromialgia. Fuera de etiqueta significa que es utilizado por los médicos debido a los beneficios demostrados, pero no está aprobado por la FDA para una condición).

La duloxetina y el milnacipran  son antidepresivos, que aumentan las concentraciones de neurotransmisores que inhiben la sensación de dolor.

Otros antidepresivos que se encontraron útiles en el tratamiento de la fibromialgia y que se usan como no recetados incluyen:

  • • Tricíclicos, como la amitriptilina que alivia el dolor y mejora el sueño
  • • Cyclobenzaprine, que funciona de manera similar a la amitriptilina
  • • Inhibidores selectivos de la recaptación de serotonina o ISRS, como fluoxetina, paroxetina y sertralina, que alivian el dolor y mejoran el estado de ánimo

Estos medicamentos funcionan para tratar la fibromialgia en pacientes con y sin depresión, por lo que no piense que su médico siente que está deprimido solo porque le recetan uno de estos medicamentos.

Otros medicamentos que han demostrado ser efectivos en la fibromialgia incluyen venlafaxina, tizanidina y tramadol, cannabinoides (medicamentos derivados de los componentes de la marihuana), gamma-hidroxibutirato (GHB) y bajas dosis de naltrexona.

Las dosis moderadas de medicamentos antiinflamatorios no esteroideos (AINE), como el naproxeno o el ibuprofeno, pueden aliviar el dolor. La mayoría de los médicos no recetan analgésicos opiáceos o tranquilizantes a excepción de los casos más graves de fibromialgia, ya que estos medicamentos no son tan efectivos para el dolor de la fibromialgia como otros tipos de dolor. Además, tomarlos a largo plazo puede afectar los órganos.

Ejercicio

Se ha demostrado que la actividad física es un valioso tratamiento para la fibromialgia, pero las actividades deben elegirse cuidadosamente y comenzar en un nivel bajo. En algunos casos, a las personas con fibromialgia se les administra la droga piridostigmina antes del ejercicio para ayudar a reducir el dolor.

Biofeedback

La biorretroalimentación enseña a las personas cómo cambiar las funciones fisiológicas, como disminuir el ritmo cardíaco acelerado o relajar los músculos tensos o apretados. Las personas que aprietan los músculos de la mandíbula pueden tener dolor en la articulación temporomandibular (TMJ), que es común en aquellos con fibromialgia.

Acupuntura

Algunos estudios han demostrado una mejoría estadísticamente significativa del dolor con la acupuntura, pero otros no. Si tienes curiosidad acerca de la acupuntura, prueba tres tratamientos. Si cree que se ha beneficiado de las sesiones, continúe con hasta seis u ocho tratamientos. Para entonces, puede decidir si la acupuntura es lo suficientemente rentable como para que pueda continuar.

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