Symtom:
Smärta
Sensoriska förändringar (kramper, sveda)
Utmattning
Doctor’s note:
Duloxetine (an SNRI) and Amitriptyline (A tricyclic) are both types of antidepressants. There is reasonable evidence this group of medications can help functional symptoms, and they are commonly prescribed. These medications are thought to work centrally on the nervous system, to dampen down pain signalling, and boost neuroplasticity. You usually need to take Antidepressants 2-6 weeks before they give full therapeutic effect.
For syndromes characterised by chronic pain and central sensitisation, use of opiods and sedatives is generally not recommended. This includes Diazepam, a benzodiazepine. Benzodiazepines have short term muscle relaxant effects, so are sometimes prescribed for short term use when there is very acute pain related to muscle spasms. It is easy to develop tolerance to these medications, so long term use (for example anything above 3 days) is not recommended.
Remember, all medication have side effects and should be used with caution. People with functional symptoms may be more sensitive to side effects than average. As a general rule, a ‘start low, titrate up slowly’ approach to dosing is recommended. Although medications can help some people cope with symptoms, overall there is limited evidence that long term prescriptions make a difference to outcomes.
