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Fibromyalgia is a complicated illness with symptoms varying in degree and from person to person. A large part of the symptoms remain a mystery to physicians, and figuring out how to treat it with minimal side effects can be quite tricky. The issue is further complicated when pregnancy with fibromyalgia is added to the equation. When dealing with pregnancy, a woman must be cautious as to what she puts into her body. What may be a small side effect for her, could be a fatal side effect for her unborn child.

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During the first trimester, the most crucial development takes place with the fetus. The brain, spinal cord, heart and gastrointestinal tract is being developed as well as the lungs and other vital organs. Anything that interferes with this development, such as medication, can have dire consequences on the fetus and mother. Knowing the risks of your prescribed medications is only half the battle. Long term affects, studies involved, and other information must also be taken into consideration. The whole ordeal can be overwhelming and confusing for the mom-to-be.

Medications for Fibromyalgia

As of the date of this post, there are only three medications used to treat fibromyalgia that are approved by the Food and Drug Administration (FDA). The three medications are:

Lyrica (pregabalin), approved in June 2007: treats seizures, pain from damaged nerves, and pain associated with shingles
Cymbalta (duloxetine hydrocholoride), approved in June 2008: treats depression, anxiety, and diabetic peripheral neuropathy
Savella (milnacipran HCI), approved in January 2009: primarily used to treat fibromyalgia and acts like an antidepressant, but not used to treat depression

These medications have a common focus of reducing pain and improving function in those with fibromyalgia. It’s unknown of what causes these medications to work, but data shows “that these drugs affect the release of neurotransmitters [chemicals that send signals from one area to another] in the brain”(“Living with Fibromyalgia, Drugs Approved to Manage Pain,” n.d.). This leads to a reduction in pain felt by the user.

Common Side Effects of These Medications

No matter which type of medication you are taking, being aware of the side effects is essential. Whether it is severe, moderate, or minimal, there are side effects with every medication. It is impossible to know all of the potential effects especially in the first few months or even years of it being released for use. However, these are the common side effects of the medications approved by the FDA to treat fibromyalgia:

Lyrica: sleepiness, dizziness, blurry vision, weight gain, trouble conectrating, swelling of the heands and feet, and dry mouth
Cymbalta: nausea, dry mouth, sleepiness, constipation, decreased appetite, increased sweating, increased risk of suicidal thinking and behavior, and depression
Savella: nausea, constipation, dizziness, insomnia, excessive sweating, vomiting, palpitations, increased heart rate, dry mouth, and high blood pressure

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Link Between Fibromyalgia Medication and Birth Defects

According to a press release in May 2016 by the American Academy of Neurology, pregabalin (more commonly known as Lyrica) may be linked to an increased risk of birth defects if taken during the first trimester of pregnancy. This discovery was found after a study was conducted on 164 women who took Lyrica during their pregnancy and 656 women who were pregnant and not taking any medications used to treat seizures(“Drug used for fibromyalgia may be linked to birth defects,” 2016, p. 3).

Results of the study:

Women taking pregabalin during the first trimester were three times more likely to result in birth defects than those women who did not.
6% of the women taking pregabalin had major birth defects
Major birth defects were heart defects, problems with the central nervous system, and issues with other organs

Despite the revealing information from the study, definitive conclusions cannot be made. However, Ursula Winterfeld, Ph.D., of the Swiss Teratogen Information Service and Lausanne University Hospital in Lausanne, Switzerland says of the study:

“…these results do signal that there may be an increased risk for major birth defects after taking pregabalin during the first trimester of pregnancy.”

Should You Take Medication During Pregnancy?

Only you can make that decision to take medication during pregnancy. It should be made with your physician’s guidance and advice, but ultimately it is your decision. There are many risks to take into consideration, and having an expert such as your doctor is the ideal person to discuss it. Read more about fibromyalgia and pregnancy.