Since 2007, Lyrica has become a popular treatment for fibromyalgia as more and more fibromyalgia patients fail to see improvement with painkillers like the non-steroidal anti-inflammatory drugs (NSAIDS). However, the use of Lyrica requires a strict dosage progression and regime as inappropriate dosage can lead to various side effects, ranging from dizzy spells to more serious side effects such as suicidal thoughts.
What is Lyrica? Lyrica or generic name, pregabalin, is the first FDA approved drug to treat fibromyalgia, in mid 2007. Currently, it is the only anti-convulsant, or antiepileptic, medication out of the three approved drugs for fibromyalgia, with the other two, Cymbalta (generic: duloxetine) and Savella (generic: milnacipran), being antidepressants approved later on. Lyrica has been used in treatment for people suffering from seizures, nerve conditions such as diabetic neuropathy, shingles, or spine injuries.
How Does Lyrica Works and Side Effects
How does Lyrica work for Fibromyalgia?
In various articles published in the Journal of Pain Research, in 2007, 2008, 2010 and 2012, Lyrica is said to help reduce overall body pain, improve sleep, reduce fatigue and increase quality of life in patients. In one particular article published in the Journal of Pain Research, Lyrica works by blocking a particular calcium channel thereby interfering with the release of excitatory neurotransmitters. In layman’s term, it reduces excitatory nerve activity which is linked to heightening pain sensitivity. However, since the actual cause of fibromyalgia is still undetermined, this explanation concluded by various research remains a theory.
In a later research published in 2010 to investigate the efficiency, safety and side effects of the drug, pregabalin is found to cause various problems in patients such as dizziness, faint, disorientation, weight gain, peripheral edema, fatigue, and cognitive dysfunction. Pregabalin also increases the risk of depression or worsen existing depression in fibromyalgia patients leading to suicidal thoughts.
Based on 5 placebo-controlled trials with a total participants of 3800, it is observed that the side effects of the drug has a linear relationship with the dosage of the drug. Higher doses are generally found to cause more side effects and increase severity of the side effects. Nevertheless, the side effects experience by each individual is non-universal and based on individual tolerability.
Recommended Use and Dosage
Despite the repercussions of the drug, pregabalin has an edge over the other two FDA approved fibromyalgia drugs, duloxetine and milnacipran, due to its unique effect in improving sleep, negligible effect on causing headaches and less severe side effects relating to the gastrointestinal tract.
The recommended dosage for pregabalin is 25–50 mg to be consumed in the night initially and increased weekly to 300-450 mg. However, the increment and ultimate dosage for every individual should be customized according to the tolerance and remedial response of the patient. The abovementioned study also suggests that pregabalin should be taken with food to reduce side effects. Patients are also advised to gradually reduce dosage and eventually stop entirely when patient sees improvement in the fibromyalgia symptoms.
- Boomershine CS. Pregabalin for the management of fibromyalgia syndrome. J Pain Res. 2010;3
- Hauser W, Bernardy K, Uceyler N, Sommer C. Treatment of fibromyalgia syndrome with gabapentin and pregabalin. A meta-analysis of randomized controlled trials. Pain. 2009;145(1–2):69–81. PubMed
- Straube S, Derry S, Moore RA, McQuay HJ. Pregabalin in fibromyalgia: meta-analysis of efficacy and safety from company clinical trial reports. Rheumatology. 2010;49:706–715. PubMed
- “Lyrica User Reviews for Fibromyalgia.” Drugs.com. N.p., n.d. Web. 22 May. 2015. Available from: http://www.drugs.com/comments/pregabalin/lyrica-for-fibromyalgia.htm