Teenager with fibromyalgia

Dear Ask The Doctor: I have been suffering from chronic fatigue and joint aches for years even though I'm only 16. My doctor diagnosed me with fibromyalgia and put me on Cymbalta but I have heard you are supposed to be over the age of 18 to take it and when I don't take it i feel very anxious and essentially high. Should continue with my medication or get a second opinion?

Dear Kassidie: Fibromyalgia is more common in adults, especifically women over 18 years old, but approximately 1%-7% of children and teenagers may be affected. It is difficult to diagnose it because there are no tests to do so, then you have to pay attention to symptoms like: sore spots in the muscles (tender points), aches and pains for at least three months, fatigue, sleeping problems, anxiety and depression, dizziness, memory problems. I recommend you to get a consultation with a Pediatric Rheumatologist; also a psychologist and a Physical therapist are very useful. The treatment options include: medication (like “Cymbalta”) may be used and there is no established age limit to take it, the problem is that the effects (safety and effectiveness)of those medications (most of them are anti depressants)in children and teenagers are not well studied and on the other hand fibromyalgia is more common in women over 18 years old. You will benefit of Cognitive Behavioral Therapy which helps you to learn what triggers the pain so you can cope with it, also muscle relaxation and stress management techniques like meditation. The exercise may help you too, because the more active you are the less pain and depression you have, to learn an exercise routine you can use a Physical Therapist to teach you. So, in summary try to get enough rest, practice a consistent exercise routine, keep yourself active and learn techniques that relieve your stress. You may consult another doctor for a second opinion, that’s up to you.