Skip to Accessibility Tools Skip to Content Skip to Footer

Expert Answer: Migraine & Fibromyalgia

Question: What medications are effective for both chronic migraine and fibromialgia?

There are 3 medications that are FDA-approved for fibromyalgia. They are:
1. Cymbalta
2. Savella
3. Lyrica

None of these 3 medications are officially FDA-approved for migraine prevention. However, they can be used “off label” to prevent migraine. The choice of which one to use if an individual has both fibromyalgia and migraine may be based on the side-effect profile for each medication. Cymbalta is FDA approved for depression and anxiety as well as fibromyalgia so would be a good choice for patients who have fibromyalgia, depression, and migraines.

Savella is only FDA-approved for fibromyalgia in the United States but is approved for depression in European Countries. Savella is a little more energizing and more likely to cause weight-loss compared to Cymbalta so may be a better choice if an individual has migraine, fibromyalgia and a lethargic type of depression or is overweight and wants to lose some weight. Lyrica is related in its chemical structure to Neurontin (Gabapentin) and can be useful when both chronic migraine and fibromyalgia are present but can cause weight gain and peripheral edema as well as sedation. However, Lyrica is not useful for depression.

Lyrica can be used with Cymbalta or Savella for the treatment of fibromyalgia but in general, Cymbalta and Savella are not used together.

My recommendation for most patients who have chronic migraine and fibromyalgia is Cymbalta and if necessary, Topamax and/or Botox if the Cymbalta is not enough for prevention of chronic migraine.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

  • Nikki Albert
    8 years ago

    thanks for the info. Lyrica works quite well for fibro I find, but not so much as a migraine preventative. Cymbalta unfortunately caused some extreme emotional fluxes. But I’ve never heard of the third and might be asking my neuro about that one… always nice to get a combo med.

  • Noreen C. Richards Frederick
    8 years ago

    After 43 years of migraines, my Dr. tried me on Cymbalta, but it didn’t seem to have any affect. I was given narcotics for my migraines until and after they came out with imitrex, but no-one will give me anything except imitrex now, and then only 9 for 2 months. I had a knee replacement 4 months ago, & needed more pain meds than most people are given because of the years of being on them, it takes more to take care of pain, so the only person who will give me the imitrex, a nurse practioner, has me listed in the “system” as a drug seeker! I do get rebound headaches from OTC pills, but when I “break the cycle” from them, whenever I have to take anything, for arthritus, etc, it starts the cycle all over again! Where do I go from here?

  • Noreen C. Richards Frederick
    8 years ago

    Thank you, I’ve been considering that lately!

  • Tara Lane
    8 years ago

    Try going to a pain clinic or getting a referral to a pain doctor. These doctors work primarily with cancer patients, but also anyone with chronic pain issues – such as migraine – and are not afraid of any of the opiates, or triptans, or steroids, or any of the other drugs which will help relieve pain. You know your own body and have to work with them as a team. All drugs are addictive, even the drugs that docs say are not. I have had 43 years of migraines so I am in the same boat as you are. I trust my pain doc implicitly and an between neurologists who specialize in migraines right now and if it weren’t for her I don’t know what I would do. She is well versed on all medications for pain, not only opiates, and will try anything when I start to get rebounds from one or another med. At this point my system is very sensitive and I know what it will and will not take, and she listens to me. This is very important in finding a good pain doc. The first one you contact, just like a neuro, may not be the right one for you, but hang in there. A good pain doc to work with your neuro is a blessing to have and is very creative about pain meds that neuro’s absolutely will not use. Good luck.

  • Holly Clark
    8 years ago

    I have fibro, depression, migraines and am on Cymbalta. For a while the Cymbata relieved both. Now, even after upping the dose, I’ve reached a plateau. However, the migraines never went away. Like Loretta, I also gained a significant amount of weight on the Cymbalta, but it is very effective at treating fibro and depression.

  • Janice Worden Lamb Clemens
    8 years ago

    I have been tried on Topamax, Depakote, Lyrica, Gabapentin, Prednisone, with no relief from the chronic , daily headaches and at least 2 or more full blown migraines a month. I really do not want to go on Cymbalta.I also was on 2 herbs that are supposed to help with migraines but they did not. I was on them for almost a year. I tried the Savella briefly but the nausea it caused was awful. Botox is not covered by my insurance so that’s not an option right now. I am very frustrated as I have been to 2 neurologists and have not had any relief. I also see my primary doctor and he really is no help. His last comment to me was , If the neurologist can’t figure it out Jan , what do you want mew to do for you? I am over these doctor’s and have stopped all of my medication except metoprolol and my thyroid medication. My headaches are still there and the fibro pain is getting worse. I still go to work everyday and I have to work to keep my insurance and also my husband starts chemo next week and we don’t know how long he will be able to continue to work so we need my income. Any suggestions are greatly appreciated.

  • Noreen C. Richards Frederick
    8 years ago

    I saw a neurologist for several years who was great, but when she left the practice, & I saw one of the others in the clinic, he said the same thing to me, “What do you want me to do??”. I had 2 disks replaced in my neck because of pain & numbness in my arms & hands, which didn’t help, now they are going to go in through the back of my neck to remove bone spurs that are pinching nerves going to my arms, & hopefully that will fix the problem, but in the meantime, the Physical Therepy PA, started me on Lyrica. I didn’t think it was doing anything till I weaned myself off it, then I had a lot of pain in my arms. along with the numbness & tight feeling, so I went back on it & pain stopped, but I have put on 8#, so since I had bariatic bypass surgery 4 years ago, I am really hoping I don’t have fibromyalgia, and will be able to stop it after the 2nd surgery on wednesday!

  • Janice Worden Lamb Clemens
    8 years ago

    Janis Elizabeth I have tried to give up caffeine, soda pop, meat , and as many preservatives as possible with no relief…but I will look into the migraine diet…I really have no other alternatives and right now I feel like no ones cares anyway..I think my husband and kids are just tired of listening to me complain that my head hurts…and even though I work for a doctor, my doctor’s either just don’t listen or just don’t care as long as I get everything they need done the only time they care is when I’m out with a severe migraine, as that’s the only time I am out sick…then they might listen but I really am depressed over the fact that no one can figure out how to help me and that no one really cares

  • JJ Elizabeth
    8 years ago

    Try the migraine diet. It helped me tremendously. Get the book “Heal Your Headache” by David Bucholz – you can get it on Amazon for under $5. Read & follow the diet. It will prep you to get off all migraine and rebound headache causing medications, foods, drinks. anything we put in our bodies that we’re not aware of causing migraine for ppl who are suseptible like us. Doctors won’t tell you this because they want to keep shoving medications at you so they can make money, and most of the time these medications cause rebound headaches anyway. Stay away from excedrin migraine & anything with caffiene. Follow the diet religiously, you will see a huge difference.

  • Loretta Lowder Brown
    8 years ago

    I am on Lyrica and Cymbalta and still continue to have migraines. I actually lost 17 pounds while on Lyrica, but when the dr. put me on Cymbalta, I gained every pound back plus, within 2 months. Not to mention the sexual side effects of Cymbalta. If it didn’t work so well for the anxiety and depression I wouldn’t take it. It’s a very frustrating medication. I tried Savella, but then I experienced tachycardia and had to discontinue.

  • Noreen C. Richards Frederick
    8 years ago

    Janis Elizabeth , I am going to look into that, since I had the bariatric surgery, it would probably be a good idea, anyhow!

  • JJ Elizabeth
    8 years ago

    Try the migraine diet. It helped me tremendously. Get the book “Heal Your Headache” by David Bucholz – you can get it on Amazon for under $5. Read & follow the diet. It will prep you to get off all migraine and rebound headache causing medications, foods, drinks. anything we put in our bodies that we’re not aware of causing migraine for ppl who are suseptible like us. Doctors won’t tell you this because they want to keep shoving medications at you so they can make money, and most of the time these medications cause rebound headaches anyway. Stay away from excedrin migraine & anything with caffiene. Follow the diet religiously, you will see a huge difference.

  • Andrea Robinson
    8 years ago

    hi I have had 2 tears in my retina and the symptoms are flashing lines around your eyes I have recently had the exact same symptoms again and was told it was a migraine even though I had no migraine pain feel ive been fobbed off can you get a migraine with no headache.

  • Migraine.com
    8 years ago

    Andrea-It is possible to experience acephalgic (or “silent”) migraine where there is no head pain. You can read more about acephalic migraine here: http://migraine.com/migraine-types/silent-migraine/

  • Amira Hamdi
    8 years ago

    Just n time , for me!

  • Shelley Saunders
    8 years ago

    why do I feel ugly and hate my body.

  • Poll