Lyrica for Fibromyalgia
Lyrica (pregabalin) is a medication developed by Pfizer, Inc. that is approved by the U.S. Food and Drug Administration (FDA) to treat the pain that occurs from damaged nerves (neuropathic pain), pain associated with the disease shingles, and the pain associated with Fibromyalgia. It can also be used along with other medications to treat seizure disorders such as epilepsy. Lyrica is a type of drug known as an anticonvulsant. The manner by which Lyrica works to treat Fibromyalgia pain is not entirely understood, however it is thought that the drug works by maintaining the balance of certain chemicals in the body and in doing so, calming overactive nerves.
Lyrica is taken in capsule form, two to three times a day. The recommended dose for Fibromyalgia is 300 to 450 mg/day, though dosing will always be tailored to the needs of the individual patient. As with any medication, Lyrica may cause side effects in some people. The most common side effects include the following: tiredness, dizziness, headache, dry mouth, nausea, vomiting, constipation, gas, bloating, elevated mood, difficulty with speech, difficulty with concentration, confusion, forgetfulness, anxiety, unsteadiness and/or loss of balance, poor coordination, uncontrollable shaking or jerking of a part of the body, twitching muscles, increased appetite and/or weight gain, swelling of the legs or arms, and back pain. Some side effects associated with the use of Lyrica can be serious, including the following: vision changes; hives, rash, itching, swelling of the face, throat, mouth, lips or tongue (signs of an allergic reaction); blisters; shortness of breath; wheezing; muscle pain or tenderness accompanied by a fever; and chest pain.
Individuals who have diabetes should use caution when taking Lyrica, as it may increase the risk of blisters and skin sores. They also may be at an increased risk of swelling in the hands and feet, as well as gaining weight. The effects of Lyrica on pregnant women are not known, so women who are pregnant, looking to become pregnant, or nursing should consult with their doctor prior to starting Lyrica to determine if Lyrica is the most appropriate choice for treatment. Individuals who are taking medications known as ACE-inhibitors (commonly used to treat high blood pressure) may be at a higher risk of experiencing swelling and hives. The risk of dizziness and sleepiness increases with concurrent use of alcohol, narcotic pain medications, or certain medications used to treat anxiety.
Although Lyrica will not work for everyone, many Fibromyalgia sufferers are able to receive a number of benefits from the drug, including reduced pain, improved sleep, and improved overall functioning. A 2008 study by Arnold et al. evaluated the safety and efficacy of Lyrica in a large sample of Fibromyalgia patients. The authors used a randomized, double-blind, placebo-controlled trial design (considered the “gold standard” of research study designs) to randomly assign 750 patients to a dose of either 300mg/day, 450mg/day, or 600mg/day of Lyrica, or a placebo (“sugar pill”). Each patient took their medication twice a day for 14 weeks. To evaluate effectiveness, the researchers compared the patients’ pain scores as measured by standard Fibromyalgia pain intensity questionnaires. In addition, each patient maintained a daily diary in which they rated the intensity of their pain on a scale of 0 to 10. When compared with those who received the placebo, the researchers found that those who took Lyrica had significantly improved pain scores. In addition, those who took Lyrica at a dose of 450mg/day and 600mg/day also reported significant improvements in the impact that Fibromyalgia pain had on their life. Finally, those treated with Lyrica (at any dose) showed significant improvements in sleep when compared to the placebo group. Some patients showed improvement in pain in as little as one week. The most common side effects experienced were dizziness and sleepiness, both of which were dose-related, meaning that the higher the dose, the greater the risk of dizziness and sleepiness. Based on their findings, the researchers concluded that Lyrica – at any of the three doses studied – is an effective method of treatment for individuals with Fibromyalgia.
Another randomized, double-blind, placebo-controlled trial also looked at the effectiveness of using Lyrica to treat Fibromyalgia. This study was divided into four phases: a one-week baseline phase, six weeks of treatment with Lyrica at a dose appropriate for each individual (or a placebo), followed by 26 weeks of continued treatment (or placebo treatment). Among those who were considered to “respond” to treatment – i.e., those who showed at least a 50% improvement in their pain – the authors found that Lyrica had lasting effects as a treatment option, with some patients having effects for up to six months. It is important to note, however, that of those who participated in the study, 17% (178 patients) had to discontinue treatment with Lyrica due to adverse side effects (Crofford et al., 2008).