Lyrica®: What do Carenity members think?

About Lyrica®

Lyrica® is a drug marketed by Pfizer. The active ingredient, or the molecule that causes the therapeutic effect, is pregabalin. It is taken orally and is available in various dosages ranging from 50 mg to 300 mg.

Pregabalin is a structural analogue of the neurotransmitter GABA (gamma-Aminobutyric acid). GABA has a role in reducing neuronal excitability and regulates the activation of the neuron to which it binds.

Indications for Lyrica®

Epilepsy

Lyrica® is an antiepileptic used in focal epilepsy in adults, in combination with another antiepileptic.

During an epileptic seizure, neurons in the brain are over-activated and over-excitable. Depending on the type of seizure, the affected neurons will be located in the same area of the brain or in different areas. One of the explanations for epileptic seizures may be related to a failure of the GABAergic synapse, i.e. the GABA pathway.

Pregabalin, therefore, reinforces the defective GABA pathway. At the same time, it decreases the release of glutamate and norepinephrine, both of which are neurotransmitters that activate neurons. It also decreases the excitability of neurons by inhibiting certain calcium channels.

"I have been taking pregabalin since November 2017, 75mg morning and night, and I haven't had any seizure since", commented a Carenity member.

This medication can also be used for anxiety disorders and for neuropathic pain.

 >>> You can find an article explaining the different types of epileptic seizure here! <<<

Generalised anxiety disorder (GAD)

Generalised anxiety disorder described an almost constant state of anxiety and of other non-specific anxiety symptoms. Pregabalin is moderately affective and is recommended by the World Federation of Societies of Biological Psychiatry as one among several fest line treatments for GAD. It has an anxiolytic (anxiety-relieving) effect similar to benzodiazepines, but with less risk of developing a dependence.

>>> Read more about GAD and its treatments here! <<<

Neuropathic pain

Neuropathic pain is pain caused by damage to the nerves (outside the brain and spinal cord). It can result from a health condition such as cancer, for example, or following a surgical operation. In these cases, the only existing treatments are painkillers or antiepileptics such as Lyrica®.

Some members who use it for fibromyalgia-related pain find their pain relieved, while others do not:
"I have been taking it for three years and it suits me, but the results differ from one person to another".

Possible side effects of Lyrica®

Some very frequent side effects (in >10% of cases) have been described: dizziness, drowsiness and headache.

Other adverse reactions have been reported (in 1-10% of cases):

• Increased appetite
• A feeling of euphoria
• Confused or disordered thinking
• Disorientation
• Attention or memory problems
• Tremor,
• Difficulty speaking
• Tingling,
• Numbness,
• Fatigue
• Insomnia,
• Double or blurred vision,
• Dizziness,
• Dry mouth,
• Constipation and bloating,
• Nausea and vomiting,
• Erectile dysfunction,
• Feeling drunkenness
• Weight gain
• Cramps,
• Joint or back pain,
• Sore throat.

Some of our members mentioned experiencing weight gain and a feeling of hunger: "I definitely have to watch what I eat more than before, eat more fibre and mind my diet to make sure I don't put on weight".

Other Carenity members have also mentioned experiencing vision problems.

Other side effects classified as uncommon (in <1% of cases) are:

• Loss of taste
• Loss of appetite
• Depression
• Strange dreams
• Agitation
• Nervousness
• Vision problems
• High blood pressure
• Heart failure
• Arrhythmia
• Fainting
• Hot flashes
• Breast pain
• Painful menstruation
• Difficulty breathing
• Stuffy nose
• Difficulty urinating
• Incontinence
• Elevated transaminases
• Abnormal blood count

Finally, rare adverse reactions have been reported: gynaecomastia (swelling of male breast tissue), allergic reaction (see next section), pancreatitis, jaundice and convulsions.

Cases of misuse, drug abuse and dependence have also been reported.

A few Carenity members commented: "You have to be very careful about how long you take this medicine. As soon as you forget to take it, you'll have withdrawal symptoms. Once you feel better, you need to progressively reduce the dosage to the point of taking small doses below 300mg".

Lyrica®: Contraindications, drug interactions and precautions for use

Lyrica® is not recommended for breast-feeding women because of the possibility of it being passed through the breast milk. For women of childbearing age, it is recommended that they use an effective contraception method during treatment. In case of pregnancy, inform your doctor to discuss possible therapeutic alternatives.

There are certain drug interactions, especially with sedatives, and even more so if they contain lorazepam or oxycodone. You should let your doctor know if you are taking such medicines.

Precautions should be taken if you have heart failure, diabetes, a history of drug or other substance dependence, or are elderly.

As described above, withdrawal symptoms may occur in some patients after discontinuation of treatment: insomnia, headaches, anxiety, nervousness, depression, nausea, diarrhoea, flu, pain, convulsions, sweating. It is therefore important to gradually reduce and space out the doses with the help of a health professional.

An increase in misuse linked to pregabalin has led to a tightening of the prescription starting in April 2019, when it was reclassified as a class C controlled substance. Under this classification, prescribers can only issue handwritten prescriptions (and not electronic prescriptions) and it is illegal to possess the drug without a prescription and to supply or sell it to others.

For patients treated with antiepileptic drugs, an increased risk of suicidal or depressive behaviour has been observed. The causes of this risk are not known and cannot be excluded with this medication; promptly report any symptoms of depression (feeling sad, difficulty concentrating, emotional detachment, etc.) or suicidal thoughts to your doctor.

Because of the risk of drowsiness associated with Lyrica®, it is best to avoid drinking alcoholic beverages.

In addition, due to its potential side effects, in some people this medicine may not be compatible with driving or operating dangerous machinery. Make sure that you tolerate the medicine well when you first take it before driving or operating machinery.

Conclusion

Pregabalin, because of its effects, is indicated for several health conditions. It is important that the patient understands his or her treatment and does not hesitate to consult a health professional for any questions regarding his or her treatment.

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Take care!