Transcript Fibromyalgia The Problems with Prescription Drug Treatment: The need to utilize alternatives Fibromyalgia diagnosis is increasing… (McLean, 2005) Why? Has Prescription Drug Use in fibromyalgia Patients become.

Fibromyalgia
The Problems with Prescription Drug
Treatment: The need to utilize alternatives
Fibromyalgia diagnosis is increasing…
(McLean, 2005)
Why?
Has Prescription Drug Use in
fibromyalgia Patients become a
Problem
 Diagnosis
is difficult
 Physicians awareness of alternatives
 Pharmaceutical companies promote
 Adverse side effects
The problem with
The Diagnosis
McLean, 2005)

Characterized by 11/18 major tender points

Mimicking conditions=Multiple Tests

No known cure

Treatment involves “managing” symptoms
The problem with
The Physicians
•Patients
trust their doctors
•(Teitelbaum, 2006)
•Prescriptions
based on initial complaint
•Physicians and research = “The Gap”
•(Saperia
& Swartzman, 2012)
•Lack
of referrals
The problem with
Pharmaceutical Companies




Visit physician's office
Attractive staff
Bring “Free” samples
Easy for physicians
(Johar, K., 2013)

Fibromyalgia Medications
(Arnold et al., 2012)


Fibromyalgia medications include:
LYRICA Pfizer Rx CYMBALTA Lilly Rx SAVELLA Forest and Cypress Rx
Adverse Side Effects

Outweigh benefits
(Roskell, et al., 2011)

May lead to further health problems
(Bergman , 2005)
The problem: Prescription drugs and the risks
◦ Serious side effects
◦ Drug dependence
◦ Birth defects
◦ Monetary effects
 Patients
become frustrated and often
discontinue use due to adverse side affects
(Häuser, et al., 2012)
Side Effects
•Lyrica’s
side effects include muscle aches
(Phizer, 2013)
•Limited
information on long-term side
effects
(Traynor et al., 2011)
•More
effective = More side effects
Drug Dependence
•Narcotics
to treat the pain
(Saperia et al., 2012)
•30%
of fibromyalgia patients use
prescription opiods
(Fitzcharles et al., 2013)
Birth Defects
•
2/3 women take medications during pregnancy
(National Birth Defects Prevention Month, 2012)





Miscarriage
Malformations
Neonatal toxicity or withdrawal
Low birth weight
Functional abnormalities
(Alwan & Friedman, 2009)

Women of all ages
need to advocate for themselves for different options
Monetary Effects

Create a financial burden for the sufferer
(Burke et al., 2012)
Burden on the family
 Expense 3X higher

(Traynor et. al., 2011)
Low productivity
 Loss of employment

Alternatives to Prescription Drugs
“Important but rarely utilized interventions” (McLean, 2005, p.663).
 Move away from traditional prescription drug treatment
Diet and Supplements




Vegetarian or vegan diet
Blue-green algae
SAMe
Super Malic
(Burckhardt, 2004)

Magnesium supplements
(Bagis et al., 2013)
Cognitive therapy





Coping skills for the illness
Stress management
Distraction
Relaxation techniques
Equally effective
(Saperia, et al., 2012)
Individual
Exercise Programs
•Regular aerobic
•(Fitzcharles
et al., 2013)
•Aquatic
•20
exercise therapy
minutes three times per week for adults
(Lima, et al., 2013)
•Yoga
•(da
exercise
Silva et al., 2007)
Physical therapy

Directed towards trigger points

Myofascial release techniques

Stretching
(Donnelly, 2002)
Acupuncture &
Trigger Point Injections

Acupuncture on the trigger points
 50% improvement in overall pain
(Chou, 2008)

Various solutions
•(Minty
et al., 2007)
Alternatives to Prescription Drugs
Dietary changes & supplements
Cognitive therapy
Individual exercise programs
Physical therapy
Acupuncture & trigger point injections
References
Alwan, S., & Friedman, J. M. (2009). Safety of selective serotonin reuptake inhibitors in pregnancy. CNS Drugs,
23(6), 493-509. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/19480468
Arnold, L. J., Crofford, L. J., Stanford, S. B., & Welge, J. A. (2012). Development and testing of the fibromyalgia
diagnostic screen for primary care. Journal of Women's Health, 21(2), 231-239. doi: 10.1089/jwh.2011.3029
Bagis, S., Karabiber, M., As, I., Tamer, L., Erdogan, C., & Atalay, A.(2013). Is magnesium citrate treatment effective
on pain, clinical parameters, and functional status in patients with fibromyalgia? Rheumatology International.
33(1), 167-172. doi: 10.1007/s00296-011-2334-8
Burckhardt, C. S. (2004). Fibromyalgia: Novel therapeutic aspects. Journal of Musculoskeletal Pain, 12(3/4), 65.
doi:10.1300/J094v12n0310
Burke, J. P., Sanchez, R.J., Joshi, A.V., Cappelleri, J.C., Kulakodlu, M. & Halpern, R. (2012). Health care costs in
patients with fibromyalgia on pregabalin vs. duloxetine. Pain Practice, 12(1), 14-22. doi: 10.1111/j.15332500.2011.00470.x
Chou, L.W., Hong, J. Y., & Hong, C.Z. (2008). A new technique for acupuncture therapy and its effectiveness in
treating fibromyalgia syndrome: A case report. Journal of Musculoskeletal Pain, 16(3), 193-198. doi:
10.1080/10582450802161978
da Silva, G. D., Lorenzi-Filho, G., & Lage, L. V. (2007). Effects of yoga and the addition of tui na in patients with
fibromyalgia. Journal of Alternative & Complementary Medicine, 13(10), 1107-1114.
doi:10.1089/acm.2007.0615
Donnelly, J. M. (2002). Physical therapy approach to fibromyalgia with myofascial trigger points: A case report.
Journal of Musculoskeletal Pain, 10(1/2), 177-190.
Fitzcharles, M., Ste-Marie, P., & Pereira, J. (2013). Fibromyalgia: Evolving concepts over the past 2 decades. CMAJ
Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne, 185(13), E645-E646.
Retrieved from http://dx.doi.org/10.1503/cmaj.121414
Häuser, W., Wolfe, F., Tölle, T., Üçeyler, N., & Sommer, C. (2012). The Role of antidepressants in the management
of fibromyalgia syndrome. CNS Drugs, 26(4), 297-307.
Johar, K. (2013). An insider’s Perspective: Defense of the pharmaceuticals industry’s marketing practices. Albany
Law Review, 76(1), 299-334. Retrieved from http:// www.albanylawreview.org
Lima, T. B., Dias, J. M., Mazuquin, B. F., da Silva, C. T., Nogueira, R. M. P., Marques, A. P. Lavado, E. L. &
Cardoso, J. R. (2013). The effectiveness of aquatic physical therapy in the treatment of fibromyalgia: A
systematic review with meta-analysis. Clinical Rehabilitation, 27(10), 892-908. doi:
http://dx.doi.org/10.1177/0269215513484772
Minty, R., Kelly, L., & Minty, A. (2007). The occasional trigger point injection. Canadian Journal of Rural Medicine,
12(4), 241-244. Retrieved from http://www.cma.ca/cjrm
McLean, S. J., & Clauw, D. J. (2005). Biomedical models of fibromyalgia. Disability & Rehabilitation, 27(12), 659665. doi: 10.1080/09638280400009048
National Birth Defects Prevention Month. (2011). MMWR: Morbidity & Mortality Weekly Report, 59(51/52), 1687.
Retrieved from http:// www.cdc.gov/mmwr
National Fibromyalgia Association (2009). National Fibromyalgia Association Retrieved from http://fmaware.org
Phizer Inc. (2013). Important Safety Information. Retrieved from http://lyrica.com.
Saperia, N. J. G., & Swartzman L. C. (2012). Openness to psychological explanations and treatment among people
with fibromyalgia versus rheumatoid arthritis. Psychology & Health, 27(3), 310-323. doi:
10.1080/08870446.2011.563852
Traynor, L. M., Thiessen, C. N., & Traynor, A. P. (2011). Pharmacotherapy of fibromyalgia. American Journal of
Health- System Pharmacy, 68(14), 1307-1319. doi:10.2146/ajhp100322
Roskell, N. S., Beard, S.M., Zhao, Y., & Le, T. K. (2011), A Meta-analysis of pain response in the treatment of
fibromyalgia. Pain Practice, 11(6), 516-527. doi: 10.1111/j.1533-2500.2010.00441.x
Teitelbaum, J. E. (2006). Why bother with natural therapies? Total Health, 27(6), 28-30. Retrieved from
http://totalhealthmagazine.com