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Adrienne Dellwo

Suicide Warnings on Fibromyalgia, Chronic Fatigue Syndrome Drugs

By May 25, 2011

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A huge number of the drugs prescribed for fibromyalgia and chronic fatigue syndrome carry a black-box warning about increased risk of suicide or suicidal thoughts. A black-box warning is reserved for the most dire of U.S. FDA alerts, and it's something we should all take seriously.

Drugs carrying this warning include two of the three approved for fibromyalgia (Cymbalta, Savella) along with all other antidepressants. For Lyrica, the other approved fibro drug, the FDA in 2008 stopped short of a black-box warning but did issue a statement saying Lyrica and other anti-seizure drugs double your risk of suicidal thoughts.

This isn't information just for us to keep in mind, either -- the people closest to us need to know about the risk as well so they can watch for signs. That point is illustrated beautifully by a reader who recently made this comment:

"I was prescribed Lyrica before any warnings appeared. The alertness of a friend literally saved my life. Even though I'm an RN, I did not connect the severe suicidal ideations with Lyrica until it was pointed out by my friend. It took 2-3 months for the symptoms to develop, and by the time I said anything, I was already planning how to commit my suicide. When we realized what was happening, I quickly weaned off the drug and notified my rheumatologist and the FDA. As the Lyrica cleared my system, the suicidal thoughts vanished. The most frustrating thing is that the Lyrica worked fabulously for the pain. .... Just be very alert with the suicide warning -- it sneaks up on you gradually, and you may find yourself planning a suicide before you realize what's happening."

If you find yourself having suicidal thoughts -- medication-related or not -- get help right away. From anywhere in the U.S., you can call:

  • 1-800-273-8255

It's a VA hotline, but anyone is welcome to call. The staffing and training there are better than at many local agencies.

More Resources:

Most of these medications require a weaning process as stopping abruptly can cause severe side effects, such as seizures, so make sure you talk to your doctor about how to wean off properly.

If you experience a severe side effect from any medication, you should report it to the FDA's MedWatch Adverse Event Reporting program.

Learn more or join the conversation!


Photo David De Lossy/Getty Images

May 25, 2011 at 7:49 am
(1) Debbie says:

I have to say off the top that I do suffer from depression, MDD, GAD, PTSD. I normally had taken prozac and my rheumy prescribed Savella. I’m telling you within 2 weeks of being off Prozac and on Savella I had to call my Psych and he told me to give it another week, no another 3 days and I was on the phone again and off the Savella. Scary how fast that med brought me right down.

Be very careful with these meds if you already have depression issues especially.

The Cymbalta I tried a long time ago, did nothing for me pain or depression wise. Lyrica I was on for a long time and didn’t affect my depression.

September 23, 2011 at 4:17 pm
(2) Crystal Rogers says:

I am too on Lyrica now and have Biopolar 1 , Ptsd , OCD , Borderlind personality disorder and I am alson on Lymitical 200 mg a day … The Lyrica has affected me some even though I take my meds and Cymbalta I couldnt breathe it swelled my throught and caused severe allergic reactions

May 25, 2011 at 8:08 am
(3) Rene says:

When I was diagnosed with Fibromyalgia and going through chemical menopause due to Breast Cancer diagnosis my rheumatologist prescribed Wellbutrin XL. It calmed me down to deal with my treatment, the menopause induced rages, but did nothing for my pain.

My memories of that time are foggy. All these fibro drugs/antidepressants make you go into a time warp where in later years you remember very little of your life during the time you took the pills. Over the years I have been prescribed Paxil, Zoloft, Savella, Lyrica, etc. and I won’t take them.

Fibro its all about rest/sleep, drinking enough water, eating the right things and keeping your activity level at an even keel.

And keeping yourself as stress free as possible.

May 25, 2011 at 8:40 am
(4) Michelle jadaa says:

I too tried lyrica and to be honest it didnt touch my fibro pain although it was great for my sciatica.I would say i get depressed from the pain and guilt of being a burden to my husband but i feel the lyrica amplified this pain.Last november i broke down and asked for depression help after frequent suicidal thoughts…..6 MONTHS later i got a call for an appointment….luckily i had already weaned myself off of the lyrica(a horrible week!)so im a little better now .But the dr never told me to get off of the lyrica and what system takes 6 months to help someone suicidal??

May 28, 2011 at 11:12 pm
(5) Colleen says:

I hear you. You are not alone. The system can stink and the vast majority of professionals don’t seem to be hearing us. Take care.

June 13, 2011 at 10:18 am
(6) Michelle says:

Last year Lyrica started advertising on TV as being FDA approved for treating Fibro. As a therapist not a doctor I hear all kind of stories. She took Lyrica when it was prescribed off label. Or given. for fibro when it was being used for sezuires. She also became suicidal and saw dancing chickens. If your doctor does not listen find a new one. A few years ago I found reseach saying General doctors after a rumatoid workup has been done to confirm fibro was better. Now I refer my clients to a GP who has more sucess with fibro. Most rumatiod docs and psychiatist would not even take time to talk to me the clients therapist about drug side effects or even what the client was taking.
I have counseled since 1992 and only met 2 psychiartist I liked and there dead now. Find a new doctor if they do not listen, and a liscensed counselor for backup. Now Lyrica has a suicide disclaimer guess you were not the only one. good luck

May 25, 2011 at 10:34 am
(7) Rachael says:

Antidepressant drugs like SSRIs have been shown to boost immune uptake, but this may be too much of a good thing especially for some up-regulated CFS sufferers. Some researchers are speculating that these drugs might boost immunity to the point that they can actually trigger autoimmune diseases or make presenting ones worse. Is your immune system in need of calming or boosting? This might determine how you will react to an antidepressant that stimulates the immune response.

“Most of us associate depression with being run down and having poor immunity to infections. The startling side effects of the immune-boosting drugs turn that notion on its head. They suggest that some people who are depressed may actually be suffering from an over-heated immune system, and that damping down inflammation could offer a brand new way to treat routine clinical depression. It’s a theory that recasts depression–one of the great plagues of our time–as a chronic inflammatory disease like rheumatoid arthritis.”

Could an overactive immune system be the trigger for some people’s life-threatening depression? Read more:

May 25, 2011 at 2:18 pm
(8) Dave says:

Is wanting to kill your doctor related to this also. Sorry, just kidding. But how about a poll on this?

May 27, 2011 at 5:23 pm
(9) Theresa says:

I could tell horror stories about what drs. have done to me. Someday I would like to write about the two years of hell I was put through. On the heels of those experiences I found out in early 2010 that I had two brain tumors. I could never have survived 28 treatments of radiation on my brain if I had not found a better Dr. He is supportive and caring. I finished the treatments on the one tumor that was attached to my optic nerve. Because it was close to my eye they could not operate. The other one is on the right side of my brain. I just had my first MRI since the treatments and it looks like the first one was stopped by the radiation. The other one that is about the size of a quarter will be operated when it shows signs of growing. So I have MRI’s in my future. The answer to what you said about “wanting to kill your Dr.” The way that I was treated almost killed me. I fell into depression because of them. I felt like giving up. No more. God will have His day with them. Or maybe a loved one of theres will go through something like this and they might think differently. Yes in the midst of it all I have one of the worst cases of fibro and chronic fatigue the Dr. has ever seen. I am soon to be 63 and I have had fibro for at least 20 years. Don’t give up. Step back and tell God you cannot take it anymore. And give it to him and don’t make a move until he leads you. Trust me I know what I am speaking of and call suicide lines, talk talk and talk. And stand up to your Dr. or take someone with you who will. God bless to you all.

May 28, 2011 at 9:02 pm
(10) Colleen says:

You are not alone in your frustration. I have had a difficult time for over a decade until 3 years ago when I was properly diagnosed and even then doctors where I’m from didn’t want to acknowledge it even though 2 specialist diagnosed it. A decade is a long time and leaves a lot of destruction / devastation along the way to forgive and overcome. This adds to the stress of being chronically ill. Invalidation, demeaning and even negligent behavior can be a lot to take in and dare we speak up about our treatment we have an even more difficult time getting help. But, we all have to draw the line somewhere and say this is enough and bring things into light otherwise our silence allows these people to continue in their ignorance and other people continue to suffer. The scary thing is others have suffered for more than a decade. One lady I know has suffered with this nonsense for over 30 years. Whether it’s 1 or 3 decades it’s too much for any one to take. I have to say most of my low moods have come from dealing with this issue or medication side-effects and both have caused much unnecessary suffering. You are not alone.

May 25, 2011 at 5:30 pm
(11) Cat says:

I’m just shaking my head in disgust… I got put on Lyrica by a rhuematologist after becomeing severely distressed, suicidal and depressed from Tramadol & other opioids. I am appaulled that not only did this doc put a depressed & suicidal person on this drug without any kind of monitoring, but that neither I nor my GP was warned that it might make my urge to kill myself STRONGER! Leaves me with the feeling (after being subjected to refusals of referrals & other docs letting me come to their office to lell me that “I don’t do fibromyalgia and I don’t do forms…” “…Go away, go home & go to bed, there is no cure and nothing you can do…” and other messages that made me feel like a total waste of space that maybe the damned doctor even wanted me to go cut my wrists so I wouldn’t waste their valuable drug kickback accumulating time with my pointless whiney appointment requests! I do take Lyrica (& a high dose too) and it does help with some of the pain (nerves) but not others (inflamation of joints).
So I guess that God(dess) if not the doctor was watching out for me.

May 27, 2011 at 5:30 pm
(12) Lucy says:

I have been depressed most of my life thanks to my bipolar, alcoholic mother and a tendency to be overly sensitive, at least as a child. I’ve attempted suicide three times and each time I get a little closer to being successful.

I was put on an SSRI years ago. At the time, they didn’t bother to mention that it could make you worse. Then they started piling on other SSRI for FMS. Pretty soon, I was into serotonin syndrome.

I stopped the SSRI but then major family conflicts erupted and I dove into depression again. They insisted on Celexa and claimed that it didn’t affect people as badly.

Since then the shrink who prescribed it has had his license yanked and he rode out of town to inflict his pain somewhere else. And I developed serotonin syndrome all over again. Plus, my depression worsened.

I went through hell withdrawing from the SSRI, at least as bad as withdrawing from the Oxycontin they gave me that didn’t really do anything for FM.

I threw out every drug that either didn’t help or made things worse. This included Lyrica, Cymbalta, Celexa, and anything else that affects SSRI, including Utram.

I’ll just grin and bear it.

May 31, 2011 at 5:26 pm
(13) Michelle says:

One issue that seems to be overlooked by doctors and patients, as well, is the possibility of Serotonin Syndrome, a potentially life threatening drug reaction that causes the body to have too much serotonin. In practice, such toxic levels are essentially impossible to reach through an overdose of a single antidepressant drug, but require a combination of serotonergic agents. The intensity of the symptoms of serotonin syndrome vary over a wide spectrum, and the milder forms are seen even at nontoxic levels, thus the need for close supervision of patients for at least the first few weeks of initiating a serotonin reuptake inhibitor (SSRI), which is when patients are more likely to have suicidal thoughts/impulses. Supervision is even more important if the individual is taking another serotonergic agent, such as migraine medicines called triptans such as Imitrex, Zomig, Frova, Maxalt, or selective serotonin/norepinephrine reuptake inhibitors (SSNRIs), such as Cymbalta and Effexor or anti-seizure meds such as Neurontin and Lyrica. Popular SSRIs include Celexa, Prozac, Zoloft, Paxil, and Lexapro.

As I am not a medical doctor, I urge readers to discuss this with their physicians. Under no circumstances should one discontinue a prescribed drug without their physician’s knowledge and supervision.

June 13, 2011 at 10:47 am
(14) JD says:

I am not even going to ask who mixed all those drugs together for you oxy and lyrica have the potentioal to cause suicidal thoughts. I hope that if you need help you go somewhere that listens to you. As a therapist with fibro many people tell me lyrica does not work for them. If you can tolerate the FM great if not ther is help out there. There are professionals that care and know what they are doing. They may not be working for an hmo or any insurance company. Good help is out there it is hard to find a licsence. therapist has to take a master(4 years) and doctrate( 4 more years) course. Find out how much a psychiatist takes in therpay and medication after his doctors degree, which does not include therapy). Doctors did not always have to update their education after they graduated. That occurrred within the last 10 years.

May 27, 2011 at 5:33 pm
(15) Heather says:

Very interesting…. I’m sorry so many of you have had such awful experiences. I was on Lyrica for a few months – I didn’t have suicidal thoughts, but the stuff made me ANGRY. Got off of it asap.

May 27, 2011 at 5:58 pm
(16) Linda says:

At the time I was on Lyrica there was no mention of suicidal tendancies. It was only as I was weaning off it because it didn’t work that I experienced suicidal thoughts. The only help I found was in an on-line discussion page where several people had made comments of similar feelings. It was good to know it was the drug.

May 27, 2011 at 7:45 pm
(17) Mary says:

Wow reading all these comments saddens me because I too have been through alot. As far as different doctors, medicines, other people telling me go natural, etc. Its been years. I can say that the Cymbalta has brought some relief and I’m real thankful. Theres other things that get in the way though. My heart goes out to all of you. Don’t give up and just keep looking up. These bodies are breaking down but our soul/spirit is alive. God be with each of you.

May 28, 2011 at 1:43 am
(18) Karen Brauer says:

I was prescribed anti-depressants for fibromyalgia when I was NOT depressed. This was prior to any black box warnings being issued. When I became suicidal, it was blamed on something else. Now everyone keeps suggesting I go on Savella. After developing serotonin syndrome with permanent brain damage from the previous meds, are you KIDDING me?

May 28, 2011 at 8:19 pm
(19) Julia A Fontaine says:

It has been a decade of FMS, now and I just had to increase the dosage on the fentanyl patch. I have been fighting that for a couple months, until I could bear it no longer. I am paranoid about how easily the docs will over prescribe or mix our drugs. I used to take Cymbalta and Gabatril along with my other meds, and during the last year I had 3 occasions where it appeared I was having a stroke. Only one doc at the ER picked it up my condition as a drug issue, but assumed it was an OD. The last time I had this reaction, I was still in this reality and was able to explain what was happening before my mind and body disconnected. I haven’t had a stroke, and once I weaned myself off the above meds I have had no further frightening events. I also have started to regain a sense of hope. I was literally w/out hope and was dreading the remaining 20-30 years I have. I think finding a good counselor that does not rely on medications has been a big improvement in my care.

June 13, 2011 at 11:01 am
(20) julia says:

julia, Your right a good counselor is important. The average psychiatrist visit is 5-10 mins. I refere all my client’s to a gp.
Fentynal is a very fusy medication the first 3 months ther are alot of side effects that should go away before increaseing dose. many people can’t take the side effects or their too serious effects. If you can manage without meds great. Then your likely Fibro seems to go in levels for some they can not even walk, others go into remission and are fine. I am a liscenced counselor that sees fibro clients. I wish more people would see liscenced counselors, who could warn them. JD

May 28, 2011 at 9:10 pm
(21) Colleen says:

Yes, I have chemical sensitivities and it’s to many medications. Some quite severe. Side-effects such as additional pain to weight gain to depression to myoclonus to seizures, etc. mostly while taking the meds & not just when weaning off. Because of the illness and these medicine side-effects, I spent 3 years in bed practically 24 hours a day. Made my illness much worse not only being undiagnosed / misdiagnosed but not treated and mistreated. Some of us have much to forgive when it comes to health care professionals.

May 28, 2011 at 10:31 pm
(22) lisa says:

no antidepressants for me ever again,i have the same stories as everyone else,all that suffer from fibromyalgia are sensitive to medications,the last one put me in the hospital,i was a mess,i broke out in hives,my throat closed,the worst part i fell in this deep scary depression,i never felt that in my life,i truly wanted to die.or hurt someone else and not think twice about it.went to a new gp,i told him i have really bad reactions to them,he said they different and you have to keep trying them.he had no clue who i was,i trusted doctors,he gave me prozac weekly,well after 2 days i was down i called his office crying and they left me for dead,i got scared and went to the hospital,i was so mad.i fired him and gave him a piece of my mind.i no longer trust doctors,its my body and i know it better than anyone.lyrica i didnt last 3 days,i felt like i had sores all over my body,and it mad me very angryyy.and weird,i kept thinking my appliances were gonna attack me or rape me,crazy.where are the doctors who went into medicine to help people,and not do it for the money or kick backs.i found a site where a scientist and doctors did more studys on antidepressants and said they work no better than a placebo,and they give falsehope to all that suffer.goggle it why antidepresants dont work.good article.

June 14, 2011 at 9:20 pm
(23) Heather says:

Lyrica made me angry, too.

May 28, 2011 at 10:48 pm
(24) lisa says:

i also feel its time to address all health issues,wheather it be mental health,depression,chronic pain-should be discussed openly without reservation especially with doctors its time to end ignorance and stigma.a person shouldnt put them selves at greater risk because of the their fear to discuss medical issues when it comes to health,all cards should be put on the table,so people are informed and can make educated decisions to prevent issues and remain healthy as possiable.i think most drugs do more harm good,im not saying they are all bad,i just think antidepressnts are not the answer for some people,i wish there was a magic bullet,i always say the best medicine you could give someone is understanding and compassion,which this world lacks.take care

May 28, 2011 at 11:27 pm
(25) Colleen says:

I agree. I have stood up for myself and some issues and it has not been easy especially in a small community. Many professionals have retaliated if they have been negligent and I’ve stood up. The good professionals understand some of the ways we have been treated and know what is rubbish and ignore it but we do need to be vocal in a way we will be listened to and with the right people. I say we need to take advantage of our right to access our information and try to ensure things are in order especially when appropriate assessment and accurate notes help with diagnosis and therefore appropriate treatment and disability benefits.

June 10, 2011 at 9:49 pm
(26) Joe Hill says:

Cymbalta nearly killed me. I developed a hypertensive crisis and an ice pick headache — the pain was truly unbelievable. I didn’t know a person could experience that much pain without passing out. The idiot doctor denied it could possibly be Cymbalta. I ignored him and lived to tell the tale.

But it’s the end of the line for me now. I’ve worked as a parttime church custodian for four years. Today they told me I have 30 days to shape up or ship out. I can’t keep up with the mowing right now, but the grass is more important than my life.

It’s the only cash I receive – about $300 per month. I can’t use food stamps to buy heating oil, gas, pay property taxes or the electric bill.

I’d like to think that my suffering and death would bring attention to these diseases and possibly help someone else have a better life. But it won’t happen. A few tears, then back to business. The U.S. is a barbaric society.

June 17, 2011 at 3:53 pm
(27) Karen says:

I too was on lyrica. I thought my worsening symptoms were due to the fibro. I had planned my suicide. Where and how were set just not when. I lost my position at work and it nearly cost me my career. I became unable to function. I took myself off lyrica but made the mistake of doing it abruptly. It was a rough time. I am now on prestique and am doing ok on it.

April 4, 2012 at 7:17 pm
(28) Lorrane says:

My daugter in law suffers with migraines and fibromyalgia.My son married her without knowing exactly what this is.He said his wife threatened to kill him.She has borderline personality ( up one minute and watch out the next). I am not being insensitive to people with this disorder,but my advice is to really inform your mate if you decide to marry.I believe he is going through hell with her ,but he just can’t leave her.She is changing who he is dealing with this.I wish her the best and I am praying for her and others with this condition. I am just scared for him her, and their children.

From Your Guide: Borderline personality disorder is an extremely serious and difficult condition, I know. I hope for everyone’s sake your daughter in law can find the right treatment. You’re definitely correct that everyone should be up front and honest about medical issues when they’re in a serious relationship. ~Adrienne

April 29, 2013 at 10:41 pm
(29) Shannon says:

Are there statistics available yet about the percentage of people with Fibromyalgia who committed suicide and/or the top causes of death for Fibro patients?

June 22, 2013 at 2:40 pm
(30) stacy says:

Im not sure if its cymbalta or the quality of life, but lately I think of suicide often. Way too often.

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