OK, I’m going to do one of those things I rarely ever do and take a hard stance on a recently published bit of reviewed research. If you’re a sufferer of Fibromyalgia, whatever you do, DO NOT TAKE THE ADVICE OF THE IDIOTS that wrote “Antipsychotics for Fibromyalgia in Adults.” Yeah. It’s that bad. I’ve taken to name calling. I think you’ll understand why by the end of this article if I do my job right.
“Antipsychotics for fibromyalgia in adults” actually only reviews one antipsychotic called Quetiapine (aka Seroquel) and compares it to an anti-depressant that’s been used for Fibromyalgia for years called amitriptyline. Most people with Fibromyalgia are very familiar with amitriptyline, so I won’t spend a lot of time on it.I spent a few years on it myself. More on that, later.
I’m also quite familiar with Seroquel. My husband and stepson have both taken it for their bipolar disorder. My grandmother also takes it for her schizophrenia and believe me, there are times my family has been very grateful for antipsychotics. If you truly have a mental illness with psychotic features, they can be truly life changing. They do a lot of people a lot of good, though I’d argue they get over prescribed as much as amitriptyline does to FMites. Of course if they aren’t meant for you, the dose is too high, or they simply don’t agree with you, they are some of the roughest medications you will ever take. How do I know this? I took my husbands on accident. Twice.
The first experience was one I never intended on repeating a second time and if the little rat that lives in my head would properly keep the memory wheel moving that tells me which pill organizer is mine, I would have avoided picking up his meds that second time, too. After that, we started keeping our organizers in separate locations, because it not only took me 20+ hours of sleep to recover from his 300mg dose, it took 4 days before I could find my way out of the fog that is Quetiapine.
The reason this article infuriates me so greatly is that under no circumstances have I ever believed that my fibromyalgia or my ME/CFS was ever caused by the depression and anxiety I feel. In fact, I didn’t have anxiety or depression problems of any kind prior to getting these ailments. THE DEPRESSION AND ANXIETY CAME AFTER THE ME/CFS AND FIBROMYALGIA. Prior to falling into the moderate and then eventually severely ill category, I was a very active, upbeat kind of person, constantly on the go, highly organize, Type A personality. In fact, for the longest time I thought they were simply a consequence of my life being destroyed by these diseases until I realized they followed their own drummer regardless of what was going on. It took me a while to figure out that they were a consequence of the changes happening to my brain and the chemistry of my body BECAUSE of the ME/CFS and Fibromyalgia.
Of course it doesn’t matter how they came to be; we should get help for them, but what this review-and the studies it is critiquing-is implying, is that the depression and anxiety are the cause of our pain and fatigue-and not the effect-and that the Quetiapine would therefore fix the problem. BIG SURPRISE; IT WON’T! And yet, they insist on stating that Quetiapine
may be considered for 4 to 12 weeks to reduce pain, sleep problems, depression and anxiety in fibromyalgia patients with major depression. Potential side effects such as weight gain should be balanced against the potential benefits.
even after admitting that all four studies were of very low quality, did not include enough participants, were too exclusionary, and in comparison with the widely used amitriptyline
Both drugs did not statistically significantly differ in the reduction of average scores for pain, fatigue, sleep problems, depression, anxiety and for limitations of health-related quality of life and in the proportion of participants reporting dizziness, somnolence and weight gain as a side effect. Compared to amitriptyline, more participants left the study due to adverse events.
In other words, neither drug was anymore effective than the other, but the Quetiapine trial saw more patients withdraw due to adverse side effects, of which don’t even discuss. I myself have tried both amitriptyline and nortriptyline, neither with much in side effects, nor with any reduction to my symptoms. Frankly, they simply do not work for me.
At best, according to the review, some patients saw up to a 30% decrease in pain, though they don’t seem to be able to say this for sure since at best, there is a very low quality of evidence.
To summarize, they are making a recommendation to use a highly problematic drug with many side effects based on very low quality results that can’t really be trusted for use over 1-4 months and this is supposed to help the fibromyalgia sufferer in the long term how exactly? Oh, they don’t say, because they fail to mention whether or not this short term therapy has any long term effects, so really we must assume it does not.
The whole thing leaves me scratching my head. Especially with my own experiences with Quetiapine. Why make the recommendation at all based on four studies which at best have VERY LOW QUALITY results? Is this really the kind of scholarship you want to rest your health upon? I certainly don’t and I definitely won’t be going to my doctor begging for Quetiapine or even another round of Amitriptyline anytime soon.