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Anti-Serotonin Drugs May Treat Fibromyalgia

DaveFoster

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Effects of antidepressant mirtazapine on fibromyalgia symptoms.

PURPOSE:
Fibromyalgia syndrome (FS) is a form of non-articular rheumatism. The main criteria are the widespread musculoskeletal pain and tender points at multiple characteristic sites which are associated with several vegetative and functional symptoms. Depression is the most frequent psychiatric concomitant of FS. Etiology is unknown, connection between disturbances of serotonin metabolism and pathogenesis is postulated. Pharmacological therapy with analgetic and nonsteroidal antiinflammatory drugs is not very effective. Positive effects were reported in some patients treated with antidepressant drugs, especially serotonergic agents.

MATERIAL AND METHODS:
In the study a novel antidepressant drug mirtazapine was used characterized by selective blockade of 5-HT2 and 5-HT3 receptors. In an open trial participated 29 patients with FS, who met 1990 ACR criteria for fibromyalgia. All were treated with mirtazapine for 6 weeks. Intensity of pain, sleep disturbances, fatigue and other symptoms were measured using visuale analogue scale, severity of depression was evaluated with HDRS and BDI.

RESULTS:
An open trial completed 26 patients, the majority of them experienced a clinical improvement at the end of the study as a consequence of > or = 40% reduced intensity of fibromyalgia symptoms as well as reduced severity of depression. The significant correlation between reduction in depression after 6 weeks of mirtazapine treatment with the reduction on all four main symptoms of FS suggests a common pathophysiology of depression and symptoms of fibromyalgia. The data thus far obtained indicate the blockade of 5-HT2 and 5-HT3 receptors with mirtazapine as an effective and promising method in FS.

CONCLUSIONS:
Further double-blind placebo-controlled study are required to confirm our results.

Effects of antidepressant mirtazapine on fibromyalgia symptoms. - PubMed - NCBI
 

thegiantess

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I find fibromyalgia extremely interesting. I knew a few people with it and both got a diagnosis after a major traumatic life event.
 

DaveFoster

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@thegiantess Interesting. I acquired it after extreme stress brought on by accelerated STEM courses, a part-time job, and protein deficiency. If CFS is a hypometabolic syndrome caused by a torpor-like state, as cited by haidut, then it's possible that fibromyalgia is similar.

Also fibromyalgia has a very strong correlation with SIBO, so it's plausible that stress leads to increased serotonin ----> weakened immunity, digestion (ileocecal valve function) -----> bacterial overgrowth and infection -----> continued loss of appetite, autoimmunity, depression, and hypometabolism.

In my case, antibiotics, antiserotonin drugs (cyproheptadine, mirtazapine), thyroid, red light, abundant nutrition, B-vitamins, along with smaller amounts of aspirin and K2, and just recently naltrexone seems to be helping, but it's too early to tell.
 

Giraffe

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I wondered about the dose they used...

full text link
The patients were treated with mirtazapine for 6 weeks (42 days), the first week with 15 mg in the evening, the next 5 weeks the dose could be increased to 30 mg in the evening.
 

thegiantess

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@thegiantess Interesting. I acquired it after extreme stress brought on by accelerated STEM courses, a part-time job, and protein deficiency. If CFS is a hypometabolic syndrome caused by a torpor-like state, as cited by haidut, then it's possible that fibromyalgia is similar.

Also fibromyalgia has a very strong correlation with SIBO, so it's plausible that stress leads to increased serotonin ----> weakened immunity, digestion (ileocecal valve function) -----> bacterial overgrowth and infection -----> continued loss of appetite, autoimmunity, depression, and hypometabolism.

In my case, antibiotics, antiserotonin drugs (cyproheptadine, mirtazapine), thyroid, red light, abundant nutrition, B-vitamins, along with smaller amounts of aspirin and K2, and just recently naltrexone seems to be helping, but it's too early to tell.

Everything you've stated seems plausible. I know Paul Jaminet thinks it has a strong infectious correlation, which makes sense really in terms of stress depressing the immune system and then becoming overcome with infectious agents.

I'll have to pass along what's worked for you to the folks I know. Good luck to you in your search for better health.
 

DaveFoster

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Everything you've stated seems plausible. I know Paul Jaminet thinks it has a strong infectious correlation, which makes sense really in terms of stress depressing the immune system and then becoming overcome with infectious agents.

I'll have to pass along what's worked for you to the folks I know. Good luck to you in your search for better health.
Thanks, I'll update this thread when I've cured myself.
 

Ashoka

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I think I'm dealing with some pretty similar issues within the last two months and they came after a series of panic episodes.

Have you been able to work with a doctor with the antibiotics and anti-serotonin stuff, Dave?
 

DaveFoster

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I think I'm dealing with some pretty similar issues within the last two months and they came after a series of panic episodes.

Have you been able to work with a doctor with the antibiotics and anti-serotonin stuff, Dave?
Yeah; my doctor did a hydrogen-breath test and that confirmed SIBO, which prompted an unsuccessful round of amoxicillin and clavulinic acid (Augmentin) followed by a round of metronidazole (Flagyl) and cephalexin (Keflex).

Cyproheptadine I got an Rx for by telling her it helps me with my mood and gut issues, which it does. Mirtazapine a got an Rx for from my psych for sleep/depression. If I could add another drug, it would be lisuride, but I'm unsure if it's safe.

I just added in naltrexone, and I think that's having a very positive effect, surprisingly.
 

DaveFoster

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Dave, I wonder what makes you reluctant? Or is it the combination of drugs?
It's the combination. Mirtazapine is mildy serotonergic (agonist of 5HT1 receptors), while lisuride is also mildy serotonergic as well. I would rather not combine the two. I think a superior option would be ritanserin in the place of mirtazapine, but again I'm not sure of the interactions.

Also mirtazapine has some undesirable noradrenergic effects, but also some powerful adrenergic antagonism (making it a great sleep-aid). It also has some interesting opioid activity, which makes it useful for depression. The constipation makes long-term cascara use necessary in my view. People who use mirtazapine have been shown to have an 8% higher risk of developing SIBO, probably due to decreased peristalsis.
 

Suikerbuik

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It's the combination. Mirtazapine is mildy serotonergic (agonist of 5HT1 receptors), while lisuride is also mildy serotonergic as well. I would rather not combine the two. I think a superior option would be ritanserin in the place of mirtazapine, but again I'm not sure of the interactions.

Also mirtazapine has some undesirable noradrenergic effects, but also some powerful adrenergic antagonism (making it a great sleep-aid). It also has some interesting opioid activity, which makes it useful for depression. The constipation makes long-term cascara use necessary in my view. People who use mirtazapine have been shown to have an 8% higher risk of developing SIBO, probably due to decreased peristalsis.

Thank you for your useful reply:hattip
 

DaveFoster

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UPDATE: I've successfully used LDN (3.5-4.5 mg), cyproheptadine (4 mg), and coffee (6-8 cups/day) to reduce fibromyalgia symptoms.

My symptoms correlate with fatigue; the higher my metabolism, the less pain I'm in. This plays into the underlying cause of fibromyalgia and CFS: a hypometabolic state mediated by estrogen and associated sympathetic response.

One such treatment option for fibro includes CoQ10, which restores energy metabolism. Peat has said that vitamin K can accomplish the same things as CoQ10, which leads me to believe K2 could be used to lessen symptoms in a similar manner.

I'm also curious as to whether vitamin E can yield similar results.
 

kaybb

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UPDATE: I've successfully used LDN (3.5-4.5 mg), cyproheptadine (4 mg), and coffee (6-8 cups/day) to reduce fibromyalgia symptoms.

My symptoms correlate with fatigue; the higher my metabolism, the less pain I'm in. This plays into the underlying cause of fibromyalgia and CFS: a hypometabolic state mediated by estrogen and associated sympathetic response.

One such treatment option for fibro includes CoQ10, which restores energy metabolism. Peat has said that vitamin K can accomplish the same things as CoQ10, which leads me to believe K2 could be used to lessen symptoms in a similar manner.

I'm also curious as to whether vitamin E can yield similar results.
What specifically are you doing for metabolism? Also, is the coffee a new addition?
 

DaveFoster

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What specifically are you doing for metabolism? Also, is the coffee a new addition?
6 cups instant coffee, 2 tsp salt, 1 cup sugar, 1 TBSP chocolate chips, 6 TBSP coconut oil, 3 g creatine monohydrate, 2 g taurine, 8 TBSP gelatin, and whole milk as needed. I blend that up and drink it throughout the day, along with OJ w/ 1 TSP baking soda in a mason jar. I eat liver and oysters as well, along with occasional shrimp. mussels, cod, and recently spaghetti squash. I often eat cottage cheese in the mornings with honey and some salt.

I take some of haidut's supplements; Energin, Pansterone, methylene blue (small amount 100 mcg or so), K2 (6 mg), aspirin (100 mg or so), and occasional Lapodin. I also take cyproheptadine (4 mg) and mirtazapine (2.5 mg), but I'm weening off the latter. I also take naltrexone (3.5-4.5 mg as mentioned.)

The pain comes back under stress (homework). Right now, I'm tapering up on aspirin as the winter comes; I might go up to 300 mg/day. I don't want to get an ulcer, though, so I'm looking into alternative antiinflammatories as well.

Some options I'm looking into include serrapeptase, cannabidiol, and White Willow bark for its salicin content, but I suppose salicin would be just as risky as aspirin.

@haidut
Do you know anything about fibromyalgia and potential treatment? I recall you saying niacinamide has very potent antiinflammatory properties and is safer than aspirin.

Peat recommends diphenhydramine (Benadryl), aspirin, and cyproheptadine (for the blockade of mast cell proliferation IIRC).
 

kaybb

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UPDATE: I've successfully used LDN (3.5-4.5 mg), cyproheptadine (4 mg), and coffee (6-8 cups/day) to reduce fibromyalgia symptoms.

My symptoms correlate with fatigue; the higher my metabolism, the less pain I'm in. This plays into the underlying cause of fibromyalgia and CFS: a hypometabolic state mediated by estrogen and associated sympathetic response.

One such treatment option for fibro includes CoQ10, which restores energy metabolism. Peat has said that vitamin K can accomplish the same things as CoQ10, which leads me to believe K2 could be used to lessen symptoms in a similar manner.

I'm also curious as to whether vitamin E can yield similar results.
I mean...is one of these things you are now taking, specifically for metabolism therefore treating fibromyalgia?
6 cups instant coffee, 2 tsp salt, 1 cup sugar, 1 TBSP chocolate chips, 6 TBSP coconut oil, 3 g creatine monohydrate, 2 g taurine, 8 TBSP gelatin, and whole milk as needed. I blend that up and drink it throughout the day, along with OJ w/ 1 TSP baking soda in a mason jar. I eat liver and oysters as well, along with occasional shrimp. mussels, cod, and recently spaghetti squash. I often eat cottage cheese in the mornings with honey and some salt.

I take some of haidut's supplements; Energin, Pansterone, methylene blue (small amount 100 mcg or so), K2 (6 mg), aspirin (100 mg or so), and occasional Lapodin. I also take cyproheptadine (4 mg) and mirtazapine (2.5 mg), but I'm weening off the latter. I also take naltrexone (3.5-4.5 mg as mentioned.)

The pain comes back under stress (homework). Right now, I'm tapering up on aspirin as the winter comes; I might go up to 300 mg/day. I don't want to get an ulcer, though, so I'm looking into alternative antiinflammatories as well.

Some options I'm looking into include serrapeptase, cannabidiol, and White Willow bark for its salicin content, but I suppose salicin would be just as risky as aspirin.

@haidut
Do you know anything about fibromyalgia and potential treatment? I recall you saying niacinamide has very potent antiinflammatory properties and is safer than aspirin.

Peat recommends diphenhydramine (Benadryl), aspirin, and cyproheptadine (for the blockade of mast cell proliferation IIRC).
Thank you for this info! Very helpful. I need to start LDN again but procrastinating because last two times my pain was so bad and felt sick at the beginning but now we have lowered beginning dose. I better get started.
I have added Aleve, for antiinflamotory which is helping fibromyalgia symptoms a lot.
I have also wanted to hear from
@haidut and suggestions on treating fibromyalgia.
 

kaybb

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6 cups instant coffee, 2 tsp salt, 1 cup sugar, 1 TBSP chocolate chips, 6 TBSP coconut oil, 3 g creatine monohydrate, 2 g taurine, 8 TBSP gelatin, and whole milk as needed. I blend that up and drink it throughout the day, along with OJ w/ 1 TSP baking soda in a mason jar. I eat liver and oysters as well, along with occasional shrimp. mussels, cod, and recently spaghetti squash. I often eat cottage cheese in the mornings with honey and some salt.

I take some of haidut's supplements; Energin, Pansterone, methylene blue (small amount 100 mcg or so), K2 (6 mg), aspirin (100 mg or so), and occasional Lapodin. I also take cyproheptadine (4 mg) and mirtazapine (2.5 mg), but I'm weening off the latter. I also take naltrexone (3.5-4.5 mg as mentioned.)

The pain comes back under stress (homework). Right now, I'm tapering up on aspirin as the winter comes; I might go up to 300 mg/day. I don't want to get an ulcer, though, so I'm looking into alternative antiinflammatories as well.

Some options I'm looking into include serrapeptase, cannabidiol, and White Willow bark for its salicin content, but I suppose salicin would be just as risky as aspirin.

@haidut
Do you know anything about fibromyalgia and potential treatment? I recall you saying niacinamide has very potent antiinflammatory properties and is safer than aspirin.

Peat recommends diphenhydramine (Benadryl), aspirin, and cyproheptadine (for the blockade of mast cell proliferation IIRC).
After listening to Haidut talk about it, I have recently added nianicimide and have had better pain control. Still in experimental stage but hopeful.
 

kaybb

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6 cups instant coffee, 2 tsp salt, 1 cup sugar, 1 TBSP chocolate chips, 6 TBSP coconut oil, 3 g creatine monohydrate, 2 g taurine, 8 TBSP gelatin, and whole milk as needed. I blend that up and drink it throughout the day, along with OJ w/ 1 TSP baking soda in a mason jar. I eat liver and oysters as well, along with occasional shrimp. mussels, cod, and recently spaghetti squash. I often eat cottage cheese in the mornings with honey and some salt.

I take some of haidut's supplements; Energin, Pansterone, methylene blue (small amount 100 mcg or so), K2 (6 mg), aspirin (100 mg or so), and occasional Lapodin. I also take cyproheptadine (4 mg) and mirtazapine (2.5 mg), but I'm weening off the latter. I also take naltrexone (3.5-4.5 mg as mentioned.)

The pain comes back under stress (homework). Right now, I'm tapering up on aspirin as the winter comes; I might go up to 300 mg/day. I don't want to get an ulcer, though, so I'm looking into alternative antiinflammatories as well.

Some options I'm looking into include serrapeptase, cannabidiol, and White Willow bark for its salicin content, but I suppose salicin would be just as risky as aspirin.

@haidut
Do you know anything about fibromyalgia and potential treatment? I recall you saying niacinamide has very potent antiinflammatory properties and is safer than aspirin.

Peat recommends diphenhydramine (Benadryl), aspirin, and cyproheptadine (for the blockade of mast cell proliferation IIRC).
Do you take the creatine for fibromyalgia/CFS symptoms ....or for something else?
 

DaveFoster

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Do you take the creatine for fibromyalgia/CFS symptoms ....or for something else?
I take creatine for the ergogenic benefits in the gym. It's also one of the few proven cognitive enhancers with no long-term side effects, along with caffeine. Anything that increases ATP production should help fibromyalgia symptoms.

No problem for the info; thanks for noting that Aleve helped. It's good to hear that NSAID's do actually help with pain from another person.
 

kaybb

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I take creatine for the ergogenic benefits in the gym. It's also one of the few proven cognitive enhancers with no long-term side effects, along with caffeine. Anything that increases ATP production should help fibromyalgia symptoms.

No problem for the info; thanks for noting that Aleve helped. It's good to hear that NSAID's do actually help with pain from another person.
Ok...I would love a cognitive boost at my age:). The ATP info is good to know...I have been wondering which function to concentrate on now.
Also, Motrin/Advil, etc. didn't do a thing. My PA told me how Aleve is different and how it works ...tried it and really makes a big difference.
That's amazing you can still work out at the gym with fibromyalgia. Good your regimen is working.
 
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