Talk:Pregabalin/Archive 1

Erowid
May I suggest the removal of the link at the bottom to Erowid Experience forums on this drug? Erowid is not a particularly helpful website in that it documents unauthorised trials by individuals of medication with illegal drugs. For example, one entry regarding Pregabalin reads "next time I'll be sure to add some pot." More worryingly, another entry states:

"I just took 300mg lyrica, 200mg elavil, 10mg percocet, and 1 fioricet. I also have one of those power energy shots that im thinking of taking when i get really tired. Looking back at all of that typed out makes me think that it may not have been my best idea ever, but i guess im just going to have to see where this takes me ... Already bored of waiting for the effects to kick in, i guess that i will just go smoke a bowl (marijuana) while i wait. "

This doesn't look like a reliable, safe or trustworthy external link as it is documenting intentional overdose, recreational use, and augmentation of Pregabalin with drugs not considered safe in concomitant use and doesn't uphold any degree of impartiality or scientific basis in its 'trials.' If there are no objections to this proposed edit within 5 days registered, I'll remove the link to the Erowid site as a preliminary measure. Thanks. Thedaveformula (talk) 17:21, 26 February 2013 (UTC)

Anxiety
I would considerably appreciate further details regarding Lyrica's efficacy in treating anxiety, as well as more information regarding Pfizer's effort to get the drug indicated for the treatment of the aforesaid disorder.


 * Well, it seems the FDA was not very excited, so the question is academic (unless someone is willing to prescribe this off-label, which is not recommended). Perhaps Google will help here. JFW | T@lk  21:31, 9 January 2006 (UTC)
 * If you are interested in scientific articles and papers, then try searching on Google Scholar or PubMed. Most of this stuff will have been peer-reviewed, which is better than the average web article. However be aware that some studies are very small scale and there is a limit to what you can get from just an abstract if the full paper isn't free. Regarding approval – it looks like the FDA and Pfizer are keeping quiet about the reasons why it failed. Note: it was General anxiety disorder that they applied for, not other forms of anxiety. --Colin 23:25, 9 January 2006 (UTC)
 * Pfizer originally tried to get Lyrica approved as a 'neuromodulator' - i.e. a drug that stopped seizures, controlled anxiety, reduced pain, and was indicated for the modulation of every other neuro as well. The FDA bounced that in a heartbeat. -Ikkyu2 15:37, 10 January 2006 (UTC)
 * As has been noted in the article, Lyrica has received a positive opinion from the European Medicines Agency/CHMP for the treatment of generalized anxiety disorder in adults. Zzorse 17:08, 5 March 2006 (UTC)
 * As of march 2009, I think there are nine studies (i.e. clinical trials) on the efficacy of pregabalin in GAD (not panic, or anything else). They were all very positive. But, they were all funded by pfizer. That does not automatically make them bad or corrupt science, but one should be wary. —Preceding unsigned comment added by 76.109.129.235 (talk) 10:16, 25 April 2009 (UTC)
 * In Europe, GAD is not off-label for Lyrica: it is "ON-label". Source: I'm reading it from the actual label right now. — Preceding unsigned comment added by 88.149.209.236 (talk) 13:42, 3 June 2012 (UTC)

Side Effects
Does the article need all those potential side effects listed? Compare to the style used in other anticonvulsant articles. Zzorse 17:08, 5 March 2006 (UTC)
 * This matter was addressed quite a while back by another user, thank you. Zzorse 20:59, 21 March 2007 (UTC)

"YES IT DOES", Side affects can be an important factor to those with other medical problems as well as to some medications the patient has been prescribed..

Re revision 12-18-10 on monitoring and reporting: Entirely anecdotal, based on my experience, and can definitely be better written and documented. However in view of how acute side effects were for me, how quickly withdrawal reversed them, and how this came about from a serendipitous consult with a rhumathologist who pointed out my edema and pain problems could very well be side effects, I believe a mention of due diligence when taking this product is necessary and helpful, and should be maintained in some form. Reviewing the litterature on Medline and elsewhere, cases such as mine are relatively frequent. —Preceding unsigned comment added by 216.59.226.23 (talk) 14:50, 18 December 2010 (UTC)

controlled substance?
Is Lyrica a controlled substance, if so why? and what drug class (schedule) is it in- is it a benzodiazipine? I can not find any information on this. thanks —Preceding unsigned comment added by 71.100.201.101 (talk) 15:54, 18 December 2007 (UTC)


 * Clicking 'Legal status' in the infobox will start you on a somewhat confusing path that eventually leads here. --CliffC (talk) 19:14, 18 December 2007 (UTC)
 * its schedule CV in the united states due to the high witch could lead to the abuse of Pregabalin  (Lyrica)   Qwh (talk) 20:46, 13 May 2013 (UTC)

off-label use in Bipolar disorder treatment
Is it possible? Could someone write some info about it? Thankyou so much! 87.117.41.250 (talk) 23:28, 5 June 2008 (UTC)
 * Yes it is possible. (Some) psychiatrists are trying quasi-routinely many new antiepileptics in off-label medication of patients with BD, especially if the side-effect profile is favourable (such as in case of e.g. gabapentin). In fact, some of the 2nd and 3d generation antiepileptics, notably carbamazepine, valproate/divalproex, lamotrigine and topiramate proved effective as mood stabilizers, so that the hope in discovering new mood stabilizers by (quasi-) systematic "trial-and-error-screening" is somewhat reasonable/justifiable, if there is a cautious risk-benefit assesment by the psychiatrist and the patient gives his or her fully informed consent. It is, however, not assumable that any new antiepileptic would be an effective mood stabilizer (i.e. a drug significantly beneficial for large proprotion of bipolar patients medicated with tolerable side-effects), if this is based only on case studies, unless several well-designed larger studies prove this on long term.--Spiperon (talk) 14:16, 30 August 2008 (UTC)

"Defraud or mislead"-section: details missing
It doesnt say what the false claims were.--84.189.123.188 (talk) 21:40, 22 October 2009 (UTC)

Possible Reproductive Effects
I was recently prescribed Lyrica (pregabalin) for lumbar disc-related bilateral radiculopathy (nerve pain) - technically an off-label use. I perceive some minor effect only, but hey, every little bit helps. I have some concern regarding possible reproductive effects, and am surprised to see no mention of these here. It seems to be standard operating procedure for drug companies to downplay possible negative effects. (Imagine if there were no legislation forcing them to tell us....)

Here's something from http://arthritis.about.com/od/pregabalin/a/Lyrica.htm:

Pfizer has agreed to study the use of Lyrica in children with fibromyalgia. Another study will be planned for breastfeeding women. As it is now, women who are pregnant or plan on becoming pregnant should notify their doctor before starting the drug. No adequate, well-controlled studies have been conducted in pregnant humans, and use is only appropriate when the potential benefit to the mother outweighs possible risk to the fetus.

Men who are planning for fatherhood should also talk with their doctor before taking Lyrica. Studies showed that the drug made male animals less fertile. Also, birth defects occurred in the offspring of male animals who were treated with pregabalin.

Also, from https://www.pfizerpro.com/product_info/lyrica_pi_warnings.jsp:

Tumorigenic Potential:   In standard preclinical in vivo lifetime carcinogenicity studies of LYRICA, an unexpectedly high incidence of hemangiosarcoma was identified in two different strains of mice [see Nonclinical Toxicology]. The clinical significance of this finding is unknown. Clinical experience during LYRICA's premarketing development provides no direct means to assess its potential for inducing tumors in humans.

In clinical studies across various patient populations, comprising 6396 patient-years of exposure in patients >12 years of age, new or worsening-preexisting tumors were reported in 57 patients. Without knowledge of the background incidence and recurrence in similar populations not treated with LYRICA, it is impossible to know whether the incidence seen in these cohorts is or is not affected by treatment.

"Pregnancy:  Increased incidences of fetal structural abnormalities and other manifestations of developmental toxicity, including lethality, growth retardation, and nervous and reproductive system functional impairment, were observed in the offspring of rats and rabbits given pregabalin during pregnancy."

"Male Fertility:  Men being treated with LYRICA who plan to father a child should be informed of the potential risk of male-mediated teratogenicity. In preclinical studies in rats, pregabalin was associated with an increased risk of male-mediated teratogenicity. The clinical significance of this finding is uncertain [see Nonclinical Toxicology]."

(Sorry for the lengthy quotes. I'll try to write up a few lines in the article on this point as soon as I can, unless someone else beats me to it.)

Heavenlyblue (talk) 23:53, 16 March 2010 (UTC)

Drug interactions section not correct
The Lyrica package insert (from Pfizer) says: "Concomitant use of pregabalin with angiotensin converting enzyme (ACE) inhibitors should be closely monitored. Life-threatening angioedema with respiratory compromise has been reported with use of pregabalin." Angioedema is associated as a side effect of ACE inhbitors, but this statement in Lyrica's package insert indicates at Pregabalin and ACE inhibitors interact and angioedema could be the result. --128.227.83.71 (talk) 20:23, 10 January 2011 (UTC)

off label use
I was given this drug for post-shingles pain, for 18 months, worked great. But the good side effect was my arthitic pain was also controlled. All promptly returned when Lyrica stopped.( Very bad pain) So now I am on a daily dose, 1 instead of 2, and have good bone pain control. Anyone else?? Can`t take other arthitic meds due to a perforted ulcer in the past. —Preceding unsigned comment added by 76.205.80.228 (talk) 17:44, 28 January 2011 (UTC)

I also take 75 mg on a daily base, less side-effects and it still works.Taksen (talk) 06:46, 9 April 2014 (UTC)

How does Lyrica help nerves heal?
My doctor recently prescribed Lyrica for relief of nerve pain. I had an episode of severe pain, specific muscle cramping and numbness for a few days (recurring from a condition after several years of only minor discomfort). He said Lyrica helps the nerve's protective covering (myelin sheath) heal faster. I didn't see this benefit specifically mentioned in Wikipedia, nor did I see a description of how this occurs. Could someone please provide a scientific explanation of the mechanism of action for the effect of Lyrica (pregabalin) on the myelin sheath? (Please be specific but not overly clinical. I have a scientific background, with a just a bit of clinical knowledge.) Thank you.

I just want to speculate seeing as noone has given a definitive answer. i dont really know and this all correct it is based on my own reading. Pregabalin is a GAD inducer therefore it raises your levels of GABA, this action of GABA apart from relaxing nerves by being generally inhibitory throughout the CNS also causes release of GrowthHormone, and switches off inflammatory signals like Interlukins that are produced in a high Glutamic acid:Gaba ratio state. This reduces inflammation which allows healing and also the GH induces healing through a cascade of other neural growth factors. I hope you've seen improvements that would not contradict this explanation.

Contraindication with THC
While apparently unknown to physicians (or at least the two I've inquired, both specialists in treating and diagnosing FMS), pharmacists seem acutely aware of contraindication of Lyrica with THC (i.e. the active ingredient in cannabis). They claim that each one increases the effect of the other to potentially dangerous results.

However, I have not been able to locate proper online resources in order to include them in the article. I suggest this issue should be investigated into. john1987 17:44, 12 December 2010 —Preceding unsigned comment added by 201.251.127.233 (talk)

look into http://www.icmag.com/modules/Tutorials/enjoyingrewards/1646.HTM people specifically combine thc and gotu kola which as also a GAD inducer and so should be pharmacologically comparable. of course there it could be a very specific interaction the pharmacist is considering, but i believe that basic principles, and suggested recepies, indicate they would synergise rather than be dangerous. it is likely that THC could enable a lower dose of a GAD inducer to be effective. also if you can find a high quality fluid extract form of gotu kola it is highly recommended and may be much safer and cheaper than Lyrica. — Preceding unsigned comment added by 220.101.100.14 (talk) 12:40, 19 April 2012 (UTC)

ANESTHESIA DOLOROSA
Morning

Has anyone used this drug for ANESTHESIA DOLOROSA ? Neuopathic pain through nerve damage to the Trigeminal nerve. Any feedback would be appreciated. Have tried numerous drugs to little or no effect.

Geraldine 25th August 2011 — Preceding unsigned comment added by GelFerg (talk • contribs) 08:24, 25 August 2011 (UTC)

Patent Expiration
There seems to be some confusion over whether the patent expires in 2013 or 2018. I can't find evidence that it has been extended past 2013 but someone has changed the expiration date to 2018 in the article. Any ideas/references? — Preceding unsigned comment added by 203.59.119.178 (talk) 14:48, 7 March 2012 (UTC)
 * I'm curious about that too — Preceding unsigned comment added by 88.149.209.236 (talk) 13:44, 3 June 2012 (UTC)

FDA approved pregabalin for neuropathic pain in spinal injury according to editor of Medscape Neurology & Neurosurgery
I am a clinical pharmacologist and I learnt from Medscape Pharmacist news that Pfizer inc. has made an announcement on 21 June 2012 that FDA has approved pregabalin (Lyrica®) for neuropathic pain in spinal injury.

Pregabalin is not in use in every neuropathic pain case, but for those cases that involved spinal injury, the numbness or phantom pain can be very disabling. Pregabalin is available in different doses, a loading dose could be very useful and the dosing schedule could be individualized by tapping off the dose gradually (titration) and spacing the dosing frequency according to patient preference. The most important prescribing information to be given to patient is that this is not a pain-killer, and the condition is not very clearly understood. So, to start pregabalin for patient with clinical sign and symptom in consistency to the approved indication, substantial communication is recommended.

Candy ChongCandychong1025 (talk) 15:12, 11 July 2012 (UTC)