Treatment

 

Drugs: 2

  1. Anti-depressants.
  2. Tricyclics: eg. Amytryptilene, Nortryptilene should have a maximum daily dose of 25 mg as larger doses cause side effects but don't increase painkilling benefits.
  3. SSRIs: eg. Fluoxetine to work efficiently needs a daily dose between 40 mg and 60 mg.
  4. Pregabalin: based on Gabapentin, and still at an experimental stage. In US, after 8 weeks on 450 mg, 50% reported less pain, less fatigue, improved sleep and few side effects.