Yvonne's story

by Yvonne Willman

I was a healthy, young 22 yr old, when I had two bouts of glandular fever. In the months following the illnesses I was struck down by excruciating, crippling muscle pain all over my body. I couldn't walk and as a result had to use a wheelchair, the pain was indescribable. At the age of 28 after years of suffering, by shear fluke I was put on an anti- depressant called "amoxapine" the original dose was 50mg as I was so depressed due to the misery of the condition. It became apparent that the pain improved slightly. To cut a long story short, over the years I have increased my dose to a maximum of 300mg, and for the past 4 years I have been completely pain free. I know these are the drugs that are taking the pain away because four years ago they were taken off the English market, and the pain was so intense I was again back in a wheelchair. My pharmacist now orders them from France for me at some considerable cost, so I live in fear that one day I will be without them again. I know amoxapine is made in America, another name for them is "ascend" and I urge you all to speak to your doctors about prescribing you this drug. I am cured and wish you all the best of luck, please, I assure you this could make you well again just like I am.

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Well done Yvonne!
by: Philippe

Hi Yvonne
Your story is fascinating. Amoxapine is a tricyclic antidepressant. Those antidepressants have long been used in chronic pain diseases such as fibromyalgia. Usually, the doses used are small but as always there are exceptions and you are an example. If you fall in the small percentages of success, say 25%, for you it is 100%. The same applies to those 75% where it does not work. For them it is 100% failure! The most important is not to loose an opportunity to be one of the 100% success.
Have you tried amitriptyline which is probably available in your country and is now a cheap generic? There are others in the same family. Probably the same dose would apply.

All new antidepressants, in the same family or a different one, should be tested against amitriptyline to see if they are any better but this is never done: too much money is in line (each "new antidepressant" has a potential of 2 billion $ profit).

I just found this review recently published:
Amitriptyline in the treatment of fibromyalgia: a systematic review of its efficacy. B. Nishishinya et al. Rheumatology 2008;47:1741?1746
The objective of this study was to assess the efficacy and safety of amitriptyline as a treatment of FM. A comprehensive computerized search in Medline (Pubmed), EMBASE and The Cochrane Library was performed. Randomized controlled trials (RCTs) comparing amitriptyline vs placebo in adult patients suffering from FM were identified, the methodological quality was assessed and the results of the main outcomes were evaluated. Ten RCTs were identified. Large clinical variability and statistical heterogeneity precluded quantitative metaanalysis. Overall, the study quality was moderate to high. Amitriptyline 25 mg/day (six RCTs) demonstrated a therapeutic response compared with placebo in the domains of pain, sleep, fatigue and overall patient and investigator impression. This benefit was generally seen at 6?8 weeks of treatment but no effect was noted at 12 weeks. Amitriptyline 50 mg/day (four RCTs) did not demonstrate a therapeutic effect compared with placebo. Neither dose of amitriptyline had an effect on tender points count. No clear statements on adverse events with amitriptyline can be made due to inconsistencies in data among the studies. A definitive clinical recommendation regarding the efficacy of amitriptyline for FM symptoms cannot be made. There is some evidence to support the short-term efficacy of amitriptyline 25 mg/day in FM.
There is no evidence to support the efficacy of amitriptyline at higher doses or for periods >8 weeks. More stringent RCTs with longer followup periods are required to determine the long-term efficacy and safety of the amitriptyline and define its role in the multidisciplinary management of FM.

You can see that your experience is different from what is reported here and we are all happy for that. Unhappily, it may not be the case for everyone.

I hope you'll carry on telling us about your experiences.
Best wishes

Michelle's comment to Yvonnes's story
by: Michelle

Yvonne, my heart goes out to you and your family. I think you are so brave. I say this because I also know the pain we have to endure from this illness. My doctor won't give me pain pills due to the fact that I am on anti-depressants. I have been feeling especially worse for the past 8 weeks. This weekend I went to the emergency hospital and the doctor who was on call heard my story and he could not believe I was only taking Tylenol extra-strength for the pain. He prescribed me Diclofenac sodium-Misoprostol 75mg/200mcg. The only problem that I have with this is the fact that it is a narcotic. The pills help me a lot with the pain but I am not keen on the fact that I could develop an addiction with them. I am so depressed due to this illness that the thought of getting up in the morning is to much. I will talk to my family doctor about your prescription and ask him if it is available in Canada. I would be so happy to live without pain. I thank you very much for your story and the information you provided us with. I'm sending you a big hug and I hope you will continue to live without pain with your meds.
Sorry about the spelling mistakes, I'm french. haha.
Thank you again Yvonne

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