Quite possibly the most vexing medical disorder of the day, fibromyalgia affects an estimated 2-8 percent of the populace. From the time it was first described by doctors in the early 1800s, it’s been called everything from a mental illness to fanciful into a new type of rheumatism. It’s not until recently that fibromyalgia has begun to be accepted and understood. Nevertheless, medical professionals believe it an idiopathic disease because its origin is currently unknown.
What can it be?
From a blend of Latin and Greek words, the term fibromyalgia means”pain” (algos) coming from the “muscles” (myo-) and “fibrous cells” (fibro-). Therefore, the disease is characterized by chronic body pain and a heightened, frequently painful reaction to stress called allodynia. Further complicating the problem for both patients and their physicians is that not all fibromyalgia symptoms are associated with pain.
Joint stiffness, sleep disturbances, and debilitating fatigue are reported by many fibromyalgia sufferers. Others experience bowel and bladder abnormalities, numbness and tingling, and cognitive dysfunction. Although the prospects for fibromyalgia sufferers have not been better, medical professionals are still playing catch-up in regards to the disorder.
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Consider the fact that the initial guidelines for treating fibromyalgia pain weren’t published until 2005! At the moment, however, doctors classify it as a central nervous system disease that’s caused by neurobiological abnormalities which produce cognitive or pain impairments for no clear reason. To put it differently, they are not sure what causes it, but they understand exactly what happens when patients have it. But even so, there’s some controversy in the medical community concerning the nature and causes of this disorder.
As we mentioned previously, experts aren’t sure what causes fibromyalgia, even though they do have a few theories. Heredity. Like most illnesses, fibromyalgia is believed to run in families, meaning that some individuals might be born with a greater chance of getting it. Injuries. It’s thought that some accidents could be so traumatic that they change how our brains process and translate pain. Infection.
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Just like a traumatic accident, it’s thought that some infections may alter the way we experience pain. Infections which were linked to fibromyalgia include: parvovirus, Lyme disease, hepatitis C, and Epstein-Barr virus. Autoimmune disorders. Once mistaken as a kind of rheumatism, some believe that fibromyalgia is caused by the body’s immune system attacking its own cells, as happens in lupus, rheumatoid arthritis, and other autoimmune disorders.
Emotional and psychological stress. The onset of fibromyalgia has been linked with increased psychological stress. As you may imagine, treating this type of complicated, often intensely personal disorder can be very challenging. Because fibromyalgia is often associated with psychiatric problems like depression, anxiety, and stress-related disorders, medication may be useful. Specifically, antidepressants have been shown to relieve the most common signs of this disease, including depression, fatigue, sleep disturbances, and pain.
Unfortunately, many patients eschew them because they have severe side effects which cause more damage than good. One atypical antidepressant, however, could offer hope to the millions afflicted by this common disorder. Used primarily in treating major depression, tianeptine is a tricyclic antidepressant that defies easy classification — similar to fibromyalgia itself. Although its mechanism of action isn’t fully understood, the drug has a mood-brightening and anxiety-reducing (anxiolytic) effect that’s rare in most antidepressants.
In actuality, many antidepressants actually increase stress in patients for the first couple weeks of use. That includes the most popular antidepressants on the market today, namely Paxil, Prozac, Zoloft, and Celexa. Far less addictive than many antidepressants and anxiolytics, the misuse rates for tianeptine are minuscule. By comparison, benzodiazepines which are utilised to decrease stress are among the most abused drugs on Earth, and popular antidepressants aren’t far behind!
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Altogether, both kinds are responsible for almost 50 percent of pharmaceutical overdose deaths annually in America! Because it was just recently accepted as a diagnosable medical disorder, just a couple of drugs have been tested for the treatment of fibromyalgia. One such evaluation that included tianeptine was completed in January 2007 in Spain. According to researchers in that study, the drug proved effective at reducing pain associated with the disease. As impressive as these results were, doctors can’t say for sure why tianeptine is successful.
Although, once more, they have many theories. For its entire history, fibromyalgia has been associated with depression, anxiety, and other psychiatric disorders. But why? Although a transparent link can be made between the secondary group of symptoms (sleep disturbances, debilitating fatigue, and cognitive impairment ) and some of the aforementioned, how can a psychiatric disorder cause bodily pain? The easiest way to answer that question is to say that pain is also a complex matter.
Pain perception entails many pathways and measures which may be altered for an assortment of reasons. These alterations could result in a constant state of pain, even if the body doesn’t experience any real, physical pain. To put it differently, something goes wrong in the wiring which makes people who suffer with fibromyalgia perceive pain differently than healthy folks. As result, a simple hug or a handshake might be excruciatingly painful for them.
Like other members of the tricyclic drug class, tianeptine has proven a lot more effective in treating the disease than selective serotonin reuptake inhibitor (SSRI) or reversible inhibitors of monoamine oxidase (RIMA). As such, it’s widely utilized in the treatment of the disorder from the countries where it’s available. But why, exactly, might it be effective? One compelling theory posits that the medication helps modulate glutamate receptors in the brain which would otherwise lead to over-arousal and may cause the sensory gating problems which might be the principal cause of fibromyalgia pain.
Although more research is required to confirm that theory, it might explain why many fibromyalgia patients that take tianeptine report almost immediate decrease in fatigue, pain, and other common signs of the disorder. To say that physicians have a ways to go to understanding fibromyalgia are a large understatement. Since they’re unsure exactly what causes it, they need to essentially work backward and treat the symptoms of this disease rather than the cause itself. In the studies which were completed thus far, tianeptine has proven remarkably effective at treating fibromyalgia pain over a protracted time period. Again, we’re not certain why this is, but explanatory theories abound. It appears just a matter of time before someone unlocks the secret of this puzzle and assists the millions who suffer from the debilitating disease.