Cymbalta is an antidepressant which helps with pain. Safinaz Mostafa, MD

Fibromyalgia and Chronic fatigue syndrome are neuroinflammatory disorders also with several others which result in allodynia something hurts that shouldnt, hyperalgesia heightened experience of pain, and paresthesia abnormal experience of pain i.e. brain zaps. Other symptoms of overstimulation of the nervous system may occur, including migraine headaches, irritable bowel syndrome, hypersensitivity to smells,tastes,sounds, and chemicals, and night sweats,among others. The core of treatment is an exercise program which very gradually increases strength and flexibility, and by decreasing the amount of stress in ones life. Many people have psychiatric symptoms as well, especially, depression, anxiety and PTSD. Not surprisingly, antidepressants are often quite helpful. Although bupropion has been helpful in your case, many people with these syndromes take SSRIs, SNRIs, and tricyclic antidepressants. The most common are desvenlafaxine, duloxetine, amitriptyline, and nortriptyline. The anticonvulsants gabapentin Neurontin and pregabalin Lyrica have been helpful to many people to reduce pain sensitivity. Many people suffer from judgmental attitudes of others who accuse them of being lazy or just making up symptoms to get pain medicine, especially opiates. Its important to have a support system that believes that you are having painful symptoms and has compassion for you. Likewise its important to have compassion for yourself and not fall into the trap of blaming or shaming yourself for your symptoms. That shaming attitude only creates more stress and alienation. When one is alone and in pain, a vicious cycle of pain, withdrawal from others, and loneliness develops which increases more pain and withdrawal. As human beings, we are programmed to get comfort and support from people in our support system, which creates the situation in which healing occurs. If your support system is dysfunctional then its important to ask others for helpjust as the writer of the email is doing. Paula F. Eagle MD 147 East 36th Street New York, NY 10016 2124480248 Cell 9177104923 FAX 2124480250 Administrative Asst Joselin Estrada 6467341797 Please be advised that emails cannot be used for communicating emergency or lifethreatening situations. The materials in this email are private and may concern Protected Health Information. Please note that email is not necessarily confidential or secure. Your use of email constitutes your acknowledgment of these confidentiality and security limitations. If you are not the intended recipient, be advised that any unauthorized use, disclosure, copying, distribution, or the taking of any action in reliance on the contents of this information is strictly prohibited. If you have received this email in error, please immediately notify the sender via telephone or return email.

Very sorry to hear about your troubles
in 2022 at our national Rheumatology meeting, there was a review lecture on “cannabis and pain” - there are very few good studies that document a true pain relieving effect, despite what patients read and hear
FDA approved Fibro meds
1) Cymbalta
2) Lyrica
3) Savella

Other meds we use - Gabapentin, amitriptyline, nortriptyline

Best wishes

Your medical and psychiatric situation/treatment needs to be reevaluated.

Wellbutrin is a good medication for depression. However, it does not do much for pain. There are 2 good meds approved by FDA to treat fibromyalgia pain. Cymbalta (duloxitine) is an antidepressant approved for fibromyalgia pain. Also Lyrica (an anti-seizure medication) is approved for this indication.

Cymbalta may be a better choice.

I believe in alternative medicine, which is why I would recommend acupuncture for most of your symptoms including pain. If you need one, you can let me know because we have one at the practice in Coral Gables.

The combination of ADHD, thyroid problems with fibromyalgia is a complex clinical situation. The use of Wellbutrin helps with energy level, associated depression, and also helps with attention. The chronic pain of fibromyalgia is thought to be associated with overactive nerves, and Pregabalin (Lyrica) has been used in some patients to relieve the pain. You can ask your doctor to try this - it is not addictive, so you do not need to worry about addiction. In addition to medications, make sure you are getting enough sleep at night and maintain physical activity within your tolerance level. 

Wellbutrin is a great choice for depression, anxiety, ADHD, and chronic pain. You may need as much as 450mg/day for maximum benefit. They market Cymbalta for this, but it is not superior to the other drugs in this class. Lyrica often targets fibromyalgia directly. Don't forget that the pain-depression cycle feeds on itself, so any way you break the cycle will help, e.g., treating the pain will relieve some of the depression and treating the depression will help the pain, as you discovered from your own experience.

Best wishes,

Gloria M. Kardong, MD, DFAPA

possibly add cymbalta.

Consultation with a neuropsychiatrist could be helpful. You might suggest that to your doctor.

Hello, duloxetine (Cymbalta) is a serotonin-norepinephrine reuptake inhibitor which is an antidepressant and has been widely used for pain management. I would consult with your provider who is currently managing your Wellbutrin to see how to best approach changing/adding any additional antidepressants. Thank you.

With history of fibromyalgia and pain issues, I will suggest trying to add a small dose of cymbalta or amitriptyline at night and following with your doctor to see outcomes. There is also a possibility of switching the Wellbutrin to cymbalta as well.