Tuesday, August 14, 2012

Carisoprodol and fibromyalgia

This is an unfortunate and chronic disease currently affecting about 2% of the US population - a large number of people, the majority of those affected being women. The symptoms are easy to describe in widely distributed pain in the body's musculature, affecting not only the muscles, but also the tendons and ligaments. The relative disability is made worse by the constant feeling of exhaustion. It's a vicious cycle. Because of the pain, sleep is disrupted. When people wake not feeling refreshed, their mood darkens. They seem to feel the pain more. So the next night, their sleep is even less. The main difficulty is the continuing failure to explain what causes the pain. The level of discomfort is aggravated by pressure on the joints, particularly the shoulders, rib cage and the hips. None of the researchers working on this disease have an explanation for this. So there's no accepted treatment although there are patterns of drug use that seem to be emerging.
There are two general approaches. One focuses on the neurotransmitters. This is comparable to the treatment for depression, assuming that either painkillers or changes to the brain's messaging system may relieve the main symptoms. Indeed, there are some doctors who suggest fibromyalgia is not a physical disease but a psychological disorder, and simply prescribe SNRI antidepressants. Whether this view is correct hardly matters. With this strategy, the attitude of patients towards the pain changes and many do report an improvement in the quality of life.
The second approach involves the use of muscle relaxers like Carisoprodol. In one sense, this is not a different strategy because the relaxants have a sedative effect, improve sleep and so lift the mood. However, Carisoprodol has been proving more popular because, used in short bursts to limit the risk of dependence, it reduces the tensions in the muscles without causing the same levels of drowsiness affecting the use of other drugs. Indeed, used under proper medical supervision, there are real improvements with fewer side effects than arise when treatment focuses on antidepressants and serotonin-related drugs.