Recommended Meds For Fibromyalgia Patients To Aid Sleep

David A. Nye MD (

Midelfort Clinic, Eau Claire, WI

From the conference
Date: 07-15-95
Subj: Benadryl

Kathy Padgett writes:

> Different people keep talking about taking Benadryl for sleep. Which
> one, how much, etc.?

Trazodone, cyclobenzaprine (Flexeril), and diphenhydramine (Benadryl) are the ones I prescribe the most. All are shorter acting and so avoid most of the daytime side effects of amitriptyline including appetite stimulation. Usual starting doses and ranges of some of the common meds:

  Drug name          Usual starting dose            Usual maximum dose

    amitriptyline       5 mgs.   2 hrs before bed     300 mgs.

    cyclobenzaprine    10 mgs.   1 hr before bed       60 mgs.

    alprazolam          0.5 mgs. 1 hr before bed        6 mgs.

    diphenhydramine    50 mgs.   1 hr before bed      300 mgs.

    trazodone          50 mgs.   at bed time          600 mgs.

Start low and gradually increase every few days to good control of FMS symptoms without excessive side effects or the maximum dose, whichever comes first. If one doesn't work, I have the patient cut back on the dose slightly, add another, and slowly taper off the first as the second is being increased in such a way as to keep sleep sound but without excessive side effects. Also be sure to read the FAQ about the other aspects of treatment. Medication alone is of little help.

> Can it be taken with 50 mg. Zoloft? In conjunction with asthma, and
> Proventil inhalor?! Thanks.

You should discuss all medication changes with your physician. He can tell you whether their would be any problem in your case.

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