Q: I have suffered from fibrocystic breast pain since I was a teenager. I was put on birth control pills at that time for severe, chronic pain. In my thirties the pain became debilitating and I began to lactate, even though I’d had a hysterectomy. I was then diagnosed with severe chronic mastitis. Surgery was performed to remove the inflamed tissue, with no guarantee that I would be pain free. I still suffered with the pain, inflammation, rashes and discharge.
Then in my forties I was diagnosed with fibromyalgia, chronic fatigue and osteoarthritis. My rheumatologist put me on Savella. This drug did help my muscle pain a little but more so the daily breast pain and tenderness. I still get flare ups that can be severe, but have finally gotten some relief from the breast pain that I have suffered from for most of my life. Please let your readers know about this drug and how it can help with chronic breast pain due to inflammation.
A: Fibromyalgia is a chronic condition that presents with widespread musculoskeletal pain, fatigue, and sleep disturbances, that may be accompanied with possible tension headaches, irritable bowel syndrome, depression, anxiety. and more. Women are more likely to develop the condition than are men. Almost 25 yeas ago the American College of Rheumatology set two criteria for the diagnosis of fibromyalgia – at least 11 out of a possible 18 positive tender points and widespread pain that lasted at least three months. However, because symptoms can come and go, newer diagnostic criteria includes widespread pain that lasts at least three months and the inability of a physician to find any other underlying condition that might cause such pain.
One of the biggest complications of the condition is a lack of sleep that can interfere with a person’s ability to function during normal waking hours. An individual may appear to get sufficient sleep; however, pain takes over and disrupts the sleep pattern throughout the night, leading to exhaustion, depression and anxiety from this poorly understood condition.
Doctors are uncertain just what triggers fibromyalgia but it is believed there may be specific genetic mutations, that physical or emotional trauma may be to blame, and that some illnesses may trigger or aggravate the condition.
Your chronic fatigue may dovetail with your fibromyalgia and your osteoarthritis is yet another painful condition that occurs because of injury, possible obesity, and the aging process that causes the cartilage on the ends of your bones wears down. The joints most commonly affected are the hips, knees and spine. The condition presents with joint pain, tenderness, stiffness, and an inability to have full flexibility of joints. All in all, the three conditions have a common denominator – pain.
Until four years ago, there were only two drugs approved for treatment of fibromyalgia – Lyrica, a nerve pain and epilepsy drug that gained FDA approval in 2007 and Cymbalta an anti-depressant/anti-anxiety drug that followed in 2008. Enter milnacipran, marketed in this country under the brand name Savella, a selective serotonin and norepinephrine reuptake inhibitor (SNRI). The drug is designed to increase the supply of serotonin and norepinephrine (neurotransmitters) in the brain. Dosing begins at 12.5 mg the first day that increases to 100 mg over a one-week period. Based on a patient’s response to the medication, a physician may increase the dosing to 200 mg daily. Side effects may include nausea, constipation, insomnia, vomiting, palpitations, dizziness, excessive sweating, hypertension and dry mouth.
In clinical trials the medication was appreciably better at reducing pain and other physical symptoms than was a placebo for fibromyalgia patients who did not suffer from depression or anxiety. Further studies are being conducted to determine whether Savella may also improve the sleep disturbances common to the condition.
As with all drugs, there are countless questions and a medical history review that should be brought to a physician’s attention before Savella or any other drug is prescribed. I don’t know if this medication is right for everyone but I’m certainly glad you found relief with it. Thank you for sharing your story that may induce other readers to make an appointment with their primary health care provider.
