Lyrica and fibromyalgia
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
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Lyrica, also known as pregabalin is a derivative of an inhibitory neurotransmitter, gamma-aminobutyric acid (GABA).
Lyrica has been approved by the FDA for diabetic nerve pain, postherapetic nerve pain, and fibromyalgia. Lyrica binds to calcium channels in the central nervous system. Its effect is felt to be due to its ability to reduce the calcium dependent release of several neurotransmitters.
Researchers at the University of Michigan evaluated the efficacy and safety of pregabalin for the treatment of fibromyalgia (FM) in an eight-week, placebo-controlled, phase II trial. The patients were treated with pregabalin doses of 150mg, 300mg, or 450mg per day or with a placebo. The total dosage was divided into three doses a day and taken for eight weeks, after a one-week baseline observation period. The primary measure of efficacy was the pain score at the end of the eight weeks. This information was derived from daily pain diaries.
Patients treated with pregabalin had statistically significant
improvement in their mean pain score compared with the placebo. Of patients treated with pregabalin, 28.9 percent had a statistically significant (greater than 50 percent) reduction in pain from baseline compared to 13.2 percent of patients treated with the placebo.
Forty-eight percent of patients in the pregabalin 450mg per day group had at least a 30 percent statistically significant reduction in pain from baseline compared to 27 percent on the placebo. The significant improvement in pain occurred as early as week one. There were significant improvements in functional measures such as sleep, fatigue, and quality of life.
The most common treatment events were sleepiness and dizziness and were considered to be dose related. Discontinuation rates due to side effects were less than 10 percent.
FM practitioners have used Lyrica in practice. The side effects most often seen are edema and sleepiness.
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