Fibromyalgia Newsletter # 5

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Fibromyalgia Newsletter # 5 Friday, 01/04/2002
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This week's News Summary

1) Article: Tai Chi May Lessen Arthritis Pain
2) Research: New Test for FMS: Algotensiometry
3) Website : The Fully-Automated Fill-in-the-Blanks FOI Letter Generator
4) Website: Do you qualify for free prescription drugs?
5) Press Release: Cypress Files IND to Begin Clinical Testing of Drug Candidate For Treatment of Fibromyalgia Syndrome
6) Article: Finding a Doctor Who Understands Complementary And Alternative Medicine
7) Research: Prevalence of Insomnia Symptoms in Patients With Sleep-Disordered Breathing
8) Article : Living within My Envelope: A How To Story
9) Press Release: Rep. Wolf Asks GAO and HHS to Investigate Oxycontin Marketing
10) Research: Modafinil in Fibromyalgia Treatment
11) Article: Review Offers Lowdown on Who Needs Vitamins

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Full Stories Are Available Via Web Links
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1)

Subject: Tai Chi May Lessen Arthritis Pain Source : Yahoo Health News by Reuters URL: <http://dailynews.yahoo.com/h/nm/20011225/hl/taichi_1.html>

NEW YORK (Reuters Health) - The ancient Chinese art of Tai Chi may offer some people with osteoarthritis relief from pain, according to the results of a study.

Twelve weeks in a Tai Chi program eased women's pain and made their daily activities more manageable, the researcher found. Previous research has suggested that the art, which focuses on improving strength, balance and flexibility through gentle movements, can help treat arthritis and lower blood pressure. More...
<http://dailynews.yahoo.com/h/nm/20011225/hl/taichi_1.html>

[AOL: <a href="http://dailynews.yahoo.com/h/nm/20011225/hl/taichi_1.html">More...</a> ]

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2)

Subject: New Test for FMS: Algotensiometry Source: Journal of Musculoskeletal Pain 9-5: 110, 2001 URL: <http://www.sover.net/~devstar/algo.htm>

New Test for FMS: Algotensiometry

Measuring Fibromyalgia: Algotensiometry

Dr. J. B. Eisinger and his team in Toulon, France produced research indicating that there may be a noninvasive, simple and cheap way to test for fibromyalgia. Using a simple blood pressure apparatus, they have found a correlation with sensitivity to cuff pressure and fibromyalgia tender points that may be specific to fibromyalgia. The systolic blood pressure is a precise measure. The sensitivity may be relative to the number of tender points. This process is called tensiometer induced myalgia (TIM). Their results indicate that greater sensitivity to the TIM is found in patients with 11 or more tender points. Eisinger J, Plantamura A, Camensuli Y, Ayavou T, Zakarian H. Provoked pain in fibromyalgia syndrome [FMS] : evaluation and correlations. More... <http://www.sover.net/~devstar/algo.htm>

[AOL: <a href="http://www.sover.net/~devstar/algo.htm">More...</a>]

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3)

Subject: The Fully-Automated Fill-in-the-Blanks FOI Letter Generator Source: The Reporters Committee for Freedom of the Press URL: <http://www.rcfp.org/foi_lett.html>

If you want definitive info on a social security topic, a FOIA request will get you the answer with the federal documents the following will enable you to generate a proper FOIA request (same as FOI)

The Fully-Automated Fill-in-the-Blanks FOI Letter Generator

This website is brought to you by The Reporters Committee for Freedom of the Press. The form provides fields for you to fill in basic information needed for a FOI request. There is a pull down menu with several agency names and addresses already available. None of the data you enter is collected or recorded. Once you have created the letter you can send it to a file on your computer or directly to your printer. More...
<http://www.rcfp.org/foi_lett.html>

[AOL: <a href="http://www.rcfp.org/foi_lett.html">More...</a>]

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4)

Subject: Do you qualify for free prescription drugs?
Source: Consumer Research Group URL: <http://www.consumerresearchgroup.com>

Do you qualify for free prescription drugs?

Here's a directory of pharmaceutical companies willing to give you free prescription drugs if you qualify for their assistance program.

Not everyone can afford insurance, not all insurance covers what you need.
This directory can help you get the medication you need. More...
<http://www.consumerresearchgroup.com>

[AOL: <a href="http://www.consumerresearchgroup.com">More...</a>]

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5)

Subject: Cypress Files IND to Begin Clinical Testing of Drug Candidate For Treatment of Fibromyalgia Syndrome Source: Cypress Bioscience Inc.
URL: <http://www.cypressbio.com>

PRESS RELEASE

CONTACT: Lisa Walters-Hoffert, Executive Vice President and Chief Financial Officer Manda Hall, Investor Relations Administrator Cypress Bioscience, Inc., Telephone: (858) 452-2323

SAN DIEGO--(BW HealthWire)--Cypress Bioscience Inc. (Nasdaq:CYPB - news) today announced that it recently filed an investigational new drug application (IND) with the U.S. Food and Drug Administration (FDA) to begin a Phase II clinical trial of milnacipran, its drug candidate for the treatment of fibromyalgia syndrome (FMS), a chronic pain disorder.

Pending normal FDA review, the company will commence clinical studies in the first half of 2002. more... <http://www.cypressbio.com/press/20011206.pdf>

[AOL: <a href="http://www.cypressbio.com/press/20011206.pdf">More...</a>]

Note: This is an Adobe Acrobat File. Get the free Acrobat Reader at:
<http://www.adobe.com/products/acrobat/readstep2.html>

[AOL: <a href="http://www.adobe.com/products/acrobat/readstep2.html">Free Adobe Acrobat Reader</a>]

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6)
Subject: Finding a Doctor Who Understands Complementary And Alternative Medicine Source: Harvard Medical Schools Consumer Health Information URL:
<http://www.intelihealth.com/IH/ihtIH/EMIHC000/8513/25859/330180.html?d=dmtC ontent>

By Miriam Wetzel, Ph.D.
Harvard Medical School

The use of complementary and alternative therapies has skyrocketed.
Magazines, TV, bookstores and the Internet are now filled with information about herbal remedies, vitamins, dietary supplements, massage, relaxation techniques and more. One result: More and more people want medical care from a doctor who understands complementary and alternative medicine.

     You may seek out such a doctor for a number of reasons. For example, you may:

     Want to explore complementary and alternative medicine under a doctor's guidance.

     Want care from a doctor who is open-minded about including complementary and alternative therapies in your care.

Already be familiar with complementary and alternative medicine but want to discuss your options with a doctor trained in conventional medicine.

Already be receiving care from a complementary and alternative medicine practitioner and want to discuss your therapy with a doctor.

Whatever your goals, you will benefit most from a doctor who neither condemns complementary and alternative medicine wholesale, nor blindly advocates it. More...
<http://www.intelihealth.com/IH/ihtIH/EMIHC000/8513/25859/330180.html?d=dmtC ontent>

[AOL: <a href="http://www.intelihealth.com/IH/ihtIH/EMIHC000/8513/25859/330180.html?d =dmtContent">More . . .</a>]

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7)

Subject: Prevalence of Insomnia Symptoms in Patients With Sleep-Disordered Breathing Source: Medscape URL:
<http://pulmonarymedicine.medscape.com/ACCP/chest/2001/v120.n06/ch1206.01.mo hs/ch1206.01.mohs-01.html>

From CHEST Prevalence of Insomnia Symptoms in Patients With Sleep-Disordered Breathing Barry Krakow, MD, Dominic Melendrez, PSG-T, Emily Ferreira, James Clark, Sleep and Human Health Institute, Albuquerque; Teddy D. Warner, PhD, Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, NM; Brandy Sisley, Sleep and Human Health Institute, Albuquerque; David Sklar, MD, Emergency Medicine, University of New Mexico School of Medicine, Albuquerque, NM

Abstract Objective:
To assess the prevalence of insomnia symptoms in patients with objectively diagnosed sleep-disordered breathing (SDB).

Design:
Retrospective medical chart review of a representative sample of patients with SDB.

Setting:
University sleep-disorders clinic and laboratory.

Patients:
Two hundred thirty-one patients with SDB were selected from a pool of approximately 2,000 patients with sleep disorders.

Measurements:
Data were extracted from intake questionnaires and polysomnographic studies.
Results: Of 231 patients with SDB diagnoses, 115 patients reported no insomnia complaints (SDB-only patients) and 116 patients reported clinically meaningful insomnia complaints (SDB-plus patients). Compared to SDB-only patients, SDB-plus patients reported significantly worse mean sleep characteristics consistent with insomnia, including sleep latency (17 min vs
65 min), total sleep time (7.2 h vs 5.6 h), and sleep efficiency (92% vs
75%). SDB-plus patients experienced significantly more psychiatric disorders, cognitive-emotional symptoms, and physical and mental symptoms that disrupted or prevented sleep. SDB-plus patients also reported greater use of sedative and psychotropic medications and had significantly more primary complaints of insomnia, restless legs or leg jerks, and poor sleep quality despite having relatively similar referral rates for sleep apnea or complaints of loud snoring.
Conclusions: Problematic insomnia symptoms were reported by 50% of a representative sample of patients with objectively diagnosed SDB. Research is needed to determine the degree to which insomnia and related symptoms and behaviors interfere with SDB treatment.

[CHEST 120(6):1923-1929, 2001. © 2001 ACCP]

Read the complete Research Study:
<http://pulmonarymedicine.medscape.com/ACCP/chest/2001/v120.n06/ch1206.01>.m ohs/ch1206.01.mohs-01.html

[AOL: <a href="http://pulmonarymedicine.medscape.com/ACCP/chest/2001/v120.n06/ch1206.
01.mohs/ch1206.01.mohs-01.html">Read the complete Research Study</a>]

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8)

Subject: Living within My Envelope: A How To Story Source: Bruce Campbell, Ph.D. mailto:Bruc-@flash.net URL: <http://home.flash.net/~brucepa/artcl_success_jwj.htm>

Honoring the body's limits offers a way to gain some control over the symptoms of chronic illness. Read JoWynn Johns' account of how she found and accepted her limits in "Living within My Envelope: A How To Story":
<http://CFIDSselfhelp.org>http://CFIDSselfhelp.org>

The article is the second in our new series "Success Stories," personal accounts of coping and recovery. Also, read earlier bi-weekly features using the new Articles Archive. Features include articles on pacing, stress management, emotions, relationships and much more. Read this Article here:
<http://home.flash.net/~brucepa/artcl_success_jwj.htm>

[AOL: <a href="http://home.flash.net/~brucepa/artcl_success_jwj.htm">Read this Article here</a>]

Our Thanks to Bruce for contributing this article for inclusion in the Fibromyalgia Community Newsletter. Thanks Bruce!

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9)

Subject: Rep. Wolf Asks GAO and HHS to Investigate Oxycontin Marketing Source: Representative Frank Wolf (R-VA) URL: <http://www.house.gov/wolf/20011219oxygao.htm>

On 12/19, Representative Frank Wolf (R-VA) sent letters to both the General Accounting Office (GAO) and the Department of Health and Human Services (HHS) requesting an investigation of the marketing of the prescription pain medication OxyContin. Wolf is the chairman of the House Appropriations Commerce, Justice, State and the Judiciary Subcommittee, which held a hearing on OxyContin on 12/11. GAO is the investigative arm of Congress.
Wolf's requests to GAO and HHS outlined a number of specific issues for investigation, including the marketing of the drug in rural areas, the manufacturer's policy for determining which doctors to market the drug to, and any direct correlation between marketing strategies of the drug and its abuse.

A press release from Rep. Wolf's office and a link to the GAO and HHS letters are available at: <http://www.house.gov/wolf/20011219oxygao.htm>.

[AOL: <a href="http://www.house.gov/wolf/20011219oxygao.htm">Read this Press Release here</a>]

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Subject: Modafinil in Fibromyalgia Treatment (Letter ) Source: Co-Cure - The Chronic Fatigue Syndrome and Fibromyalgia Information Exchange URL:
<http://listserv.nodak.edu/scripts/wa.exe?A2=ind0106C&L=co-cure&P=R740&D=0>

Journal: J Neuropsychiatry Clin Neurosci 2001 Nov;13(4):530-531 Authors and Affiliations: JAMES L. SCHALLER, M.D., M.A.R., Chester County Research Center, West Chester, PA and DAVID BEHAR, M.D., Eastern Pennsylvania Psychiatric Institute, Philadelphia, PA NLM Citation: PMID: 11748325

SIR: Modafinil has shown benefits in fatigue-related disorders such as multiple sclerosis and various forms of neurological fatigue.1,2 We report the successful use of modafinil for fibromyalgia (FM) fatigue in 4 patients in an open study with naturalistic on-off experiences. A rheumatologist and another physician confirmed each diagnosis of FM.

FM affects 2% of the population and is characterized by chronic musculoskeletal pain (especially at characteristic soft-tissue trigger sites); severe fatigue, typically lasting >24 h with minimal activity; nonrestorative sleep; and mood abnormalities.3–5 The American College of Rheumatology adds the criterion of widespread pain for 3 months with tenderness in at least 11 of 18 specific trigger-point sites.6

We excluded 2 patients for comorbid secondary major depression (MD) until they went into full remission on their antidepressants, confirmed by two MD research scales, to remove the variable of modafinil antidepressant augmentation.7,8All patients had physical exams and laboratory testing excluding Lyme disease, Ehrlichia equi and E. chaffeensis, Babesia microti, rheumatoid or spinal arthritis, major sleep disorders, and abnormal cervical and brain MRIs.

After an average 18 months of medical care, they found minimal relief. None could stay awake 16 hours on 3 consecutive days, shop routinely, provide basic childcare, drive over an hour per day, balance a checkbook, maintain a
30-hour work week, or cook routinely. Patient expectations for relief from this trial were very low because of past failures.

Two FM patients reported some beneficial effects of depression on day one at
100 mg q A.M., which were nevertheless incomplete. Weekly dose adjustments upward in 50-mg increments and the addition of an afternoon dose met with reports of highly significant benefit by all patients.
After titration adjustments were finalized over 3 weeks, all reported a sustained increase in functional capacity. Global Assessment of Functioning average improvement was a change from 55 to 70; that is, from moderate impairment to minimal impairment.

All patients had a strong desire to continue their treatment because they now reported being "functional," able to work or to care for their children.
Fatigue improved; all patients reported highly significant improvement in alertness and a reduced need for disruptive naps. They received unsolicited comments about their improvement from their children, spouses, employers, or parents, who were unaware of the modafinil trial. Benefits persisted over 3 continuous months at the same dose.

Alertness benefits were lost if a breakfast modafinil dose was skipped.
Benefits returned quickly the following day if modafinil was restarted.
Each patient missed at least 2 days of medication because of forgotten doses or a lost prescription. They reported a full return of fatigue and impairment that day. These mishaps represent naturalistic "on-off"
experiments, supporting the immediate efficacy of modafinil. This immediate effect contrasts with our clinical expectations of gradual benefits.

The mean dose was 250 mg per day with a range of 150 to 300 mg. Patients took a dose of 150–200 mg in the morning, and half of them took an extra 50 mg or 100 mg in the early afternoon. One patient reported slight anxiety during week one, which resolved with a 50-mg dose reduction. We experienced inconclusive results in 3 patients, not included in our report, who dropped out or were lost to follow-up for reasons such as relocation.

The fatigue of FM causes marked impairment and has no definitive single treatment. Modafinil is a potential treatment option worthy of larger clinical trials.

Key Words: Disorders • Sleep Disorders

REFERENCES

Rammohan KW, Rosenberg JH, Pollak CP, et al: Provigil (modafinil):
efficacy for the treatment of fatigue in patients with multiple sclerosis.
Neurology 2000; 54:A24

Cochran JW: Effect of modafinil on fatigue associated with neurological illnesses. J Chronic Fatigue Syndrome 2001; 8:65-70

Matsumoto P: Fibromyalgia syndrome. Nippon Rinsho 1999; 57:364-369

Cathebras P, Lauwers A, Rousset H: Fibromyalgia: a critical review. Ann Med Interne (Paris) 1998; 149:406-414

White KP, Speechley M, Harth M, et al: The London fibromyalgia epidemiology study: the prevalence of fibromyalgia syndrome in London, Ontario. J Rheumatol 1999; 26:1570-1576[Medline]

Wolfe F, Smythe HA, Yunus MB, et al: The American College of Rheumatology
1990 criteria for the classification of fibromyalgia: report of the multicenter criteria committee. Arthritis Rheumatol 1990; 33:160-172

Menza MA, Kaufman KR, Castellanos A: Modafinil augmentation of antidepressant treatment in depression. J Clin Psychiatry 2000;
61:378-381[Medline]

DeBattista C, Solvason HB, Kendrick E, et al: Modafinil as an adjunctive agent in the treatment of fatigue and hypersomnia associated with major depression. New Research Program and Abstracts, American Psychiatric Association 154th Annual Meeting, May 9, 2001, New Orleans, LA. Abstract NR532:144

Co-Cure Archived Article:
<http://listserv.nodak.edu/scripts/wa.exe?A2=ind0106C&L=co-cure&P=R740&D=0>

[AOL: <a href="http://listserv.nodak.edu/scripts/wa.exe?A2=ind0106C&L=co-cure&P=R740& D=0">Read the Co-Cure Archived Article here</a>]

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Subject: Review Offers Lowdown on Who Needs Vitamins Source: Yahoo Health News by Reuters URL: http://dailynews.yahoo.com/h/nm/20020102/hl/vitamins_1.html

NEW YORK (Reuters Health) - Most people could probably benefit from taking a multivitamin, say researchers at the Harvard School of Public Health, but popping a pill can't erase the health effects of a poor diet and a sedentary lifestyle.

Drs. Walter C. Willett and Meir J. Stampfer review the evidence for and against using various vitamin supplements to prevent disease in a recent issue of The New England Journal of Medicine (news - web sites).

``Substantial data suggest that higher intakes of folic acid, vitamin B6, vitamin B12 and vitamin D will benefit many people, and a multivitamin will ensure an adequate intake of other vitamins for which the evidence of benefit is indirect,'' they write.

Taking a multivitamin is particularly important for women who may become pregnant, people who drink one or two alcoholic beverages daily and urban residents who may not be able to afford to eat enough fruits and vegetables, the authors note.

Elderly people should also take a multivitamin, the report indicates, because they tend to have a difficult time absorbing vitamin B12 and to be deficient in vitamin D. And vegans might also want to consider a multivitamin because they may lack vitamin B12, the researchers suggest.

Willett and Stampfer highlight the benefits of folic acid for women of child-bearing age, because the nutrient can prevent them from having a child with neural tube defects.

``We also believe that vitamin E supplements are reasonable for most middle-aged and older Americans who are at increased risk for heart disease,'' the team adds.

But the authors emphasize that a vitamin pill is no substitute for a healthy diet because foods contain additional important components, such as fiber and essential fatty acids.

Furthermore, ``a vitamin supplement cannot begin to compensate for the massive risks associated with smoking, obesity or inactivity,'' the doctors warn.

``Given the greater likelihood of benefit than harm, and considering the low cost, we conclude that a daily multivitamin that does not exceed the recommended daily allowance (RDA) of its component vitamins makes sense for most adults,'' the researchers write.

SOURCE: The New England Journal of Medicine 2001;345:1819-1824.

Full Article: <http://dailynews.yahoo.com/h/nm/20020102/hl/vitamins_1.html>

[AOL: <a href="http://dailynews.yahoo.com/h/nm/20020102/hl/vitamins_1.html">Full Article</a>]

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