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More recently, Moldofsky published a brief review of the literature regarding sleep disorders and soft-tissue tender- ness.13 As a result of this research on sleep disorders and FMS, it was presumed that patients with FMS might show clinical improvement with respect to soft-tissue tenderness if the quality of their sleep was improved.9,10 This led to the prescription of low doses of various antidepressant medications in an effort to induce deeper sleep, which clinically seemed to help many patients with FMS (at least in the short term)

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Most providers recommend staying on a stable dose of Ozempic before adding topiramate to help distinguish which medication is causing specific side effects