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20 May 2005
Fibromyalgia Sufferers Helped By Cough Remedy 
A new study from the University of Florida reports how dextromethorphan temporarily reduces the intensity of fibromyalgia "wind-up," a snowballing pain response to minor, repetitive physical contact. The study appears in The Journal of Pain. Fibromyalgia is an incurable illness that causes widespread muscle aches, stiffness, fatigue and sleep disturbances. An estimated 10 million Americans suffer from the condition, most of them women. Treatments include pain medication, exercise, stretching, sleep management and psychological support. The underlying cause of fibromyalgia remains unknown but it is believed that the brain and spinal cord somehow magnify pain signals to abnormally high levels. Previous studies at other institutions had shown that dextromethorphan blocks the action of a chemical messenger called N-methyl-D-aspartate, or NMDA, which relays pain impulses in the spinal cord. Many fibromyalgia researchers have theorized that wind-up is caused by abnormalities in the spinal-cord structures that process NMDA. The new study did not establish any guidelines for using dextromethorphan clinically, but it suggests the drug may eventually be an option for treating fibromyalgia and other conditions involving heightened pain sensitivity, said Roland Staud, the study's principal author. "I think it's one piece of the mosaic," Staud said. "We currently have no single therapy in chronic pain that has a big effect. So what this really means for chronic pain patients is that they need to use a whole host of different interventions to decrease the pain they have. And in this, dextromethorphan may have a role in the future." Staud cautioned that fibromyalgia patients should not resort to self-medicating by taking cough syrups for pain. "Like every medication, dextromethorphan has side effects," he said. "At high doses, patients can have problems related to memory and confusion." Fibromyalgia expert Laurence Bradley, with the University of Alabama said the study was promising but more research was needed. "It would be a disservice to start to recommend that either patients or physicians begin experimenting right away with dextromethorphan, because I think there's some important questions about how to minimize the side effects with this agent."
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