A lot of the drugs prescribed for fibromyalgia and chronic fatigue syndrome are called "reuptake inhibitors," including two FDA-approved fibromyalgia drugs -- Cymbalta (duloxetine) and Savella (milnacipran). But do you understand what reuptake really means?
When your brain transmits messages from one brain cell (neuron) to another, it does so by releasing specialized chemicals called neurotransmitters. After awhile, the space between the cells basically gets cluttered up with a lot of used neurotransmitter. It's kind of like opening your mail and ending up with a pile of empty envelopes -- the envelopes were important for getting the mail to you, but you no longer need them. Your brain cleans up the mess by reabsorbing the neurotransmitters so they can be recycled. That process is called reuptake.
Researcher theorize that the brains of people with fibromyalgia, chronic fatigue syndrome and a host of other neurological problems either have too little of certain neurotransmitters or don't use them properly. This kind of neurological dysregulation is likely behind brain fog, pain amplification, and many more of our symptoms.
Here's another analogy to explain how this works (With apologies to my fellow arachnophobes):
Imagine a spider trying to use a strand of web to get from a chair to a table. It shouldn't be a problem, but an oscillating fan across the room keeps turning that direction and blowing away the web before the spider can get across. Now imagine that someone changed the speed on the fan so that it oscillated more slowly. Now, the spider has enough time to cross the gap before the web is blown away.
The spider is the message, the web is neurotransmitter, and the fan is reuptake. When you slow reuptake, the message has enough neurotransmitter to get where it's going. Reuptake inhibitors don't increase the total amount of neurotransmitter in your brain, but they do increase the amount that's available to use.
Modern reuptake inhibitors target specific neurotransmitters -- serotonin, and sometimes norepinephrine as well. They're called:
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin norepinephrine reuptake inhibitors (SNRIs)
These drugs help a lot of people, but they have a high side-effect risk. One problem is that we don't have neurotransmitter deficiencies in every area of the brain, so the medication may improve transmission in one area while disrupting it in another. High levels of available neurotransmitter can be even more dangerous than low levels. If you're taking an SSRI or SNRI, be sure you're familiar with the symptoms of serotonin syndrome.
To see the symptoms linked to neurotransmitter deficiencies, read:
Those articles talk about non-drug treatments as well.
Have you taken SSRIs or SNRIs? How did they work for you? Does this help you understand how these drugs work? Leave your comments below!
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