instruction: hello doctor I was diagnosed with fibromyalgia a few years ago over the past three years it has gotten much worse I take lyearica two times a day and tramadol as needed for the pain I still have a great deal of pain every day the lyearica makes me feel like I cannot think straight and the tramadol just does not work anymore I was prescribed cymbalta which I took for approximately two years it did nothing for me either it was after that I started taking lyearica I have been taking it now for about six months I recently saw my provider and he did some trigger point injections which do help in the areas injected he told me he does not know what else to do for me I just feel like there are no doctors that want to even try to help people with fibromyalgia especially those with which all the current medications do not work I am terribly frustrated and very tired of being in pain every day I never get a break from the pain anymore what other treatments are out there now anything new that I may have not heard of any help would be greatly appreciated I work full time and I just do not want to be so miserable while doing it apart from lyearica and tramadol I am also taking estradiol progesterone levothyearoxin and fluoxetine
output: hi fibromyalgia is a very frustrating condition but with the help of the patient a doctor can treat it I have treated my patients with all the drugs you have mentioned by managing the doses but I always ask my patients to do meditation that would help the most in this problem in your case I would recommend you to take lyearica pregabalin at the dose of 50 my in the night time which would not affect your thinking process you should also take cymbalta at doses of 60 my per day your doctor would adjust these doses according to the symptoms you have been getting as well as the side effect profile I hope this helps ash thyearoid stimulating hormone