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Re: Neurontin vs. Lyrica » Caedmon

Posted by yxibow on April 26, 2006, at 3:00:26

In reply to Neurontin vs. Lyrica, posted by Caedmon on April 25, 2006, at 23:48:57

> So, what is the difference between Neurontin (gabapentin) and Lyrica (pregabalin)? I know that they are supposed to be similar structurally and wrt their mechanisms of action. Lyrica has better bioavailability at higher doses. Is that it?
>
> I seem to hear better things about Lyrica than Neurontin, maybe because it's new. BUT, don't they pretty much do the same thing?
>
> - C

The only similarity between the two drugs is that they're both manufactured by Pfizer and they are both being pursued and marketed for various forms of neuropathic pain equally besides for epilepsy.

They are different structurally. Neurontin, gabapentin, is an isomer of GABA itself that can cross the blood-brain barrier unlike GABA supplements.

Lyrica, Pregabalin, while having only one more Carbon atom than Neurontin works a litte bit differently. However, they both bind to the A2D subunit of voltage-gated calcium channels.

Neurontin is a DEA unscheduled Rx drug, Lyrica is a DEA schedule V Rx drug. It is very unusual for any drug to be put into Schedule V. It originally was going to be C-IV but I guess the FDA changed its mind and it is C-V. Some people found Lyrica "euphoric" in a test and it was enough to Schedule it. Go figure the DEA/FDA.

Neurontin has less side effects than Lyrica, however Lyrica could be more effective than Neurontin in some individuals so I suppose this stands to reason. Neurontin is eliminated by the body after a certain point and is useless beyond that while Lyrica has a nearly linear dose to elimination line.

Lyrica, just like any other AED can actually potentiate seizures if too many other GABAnergic drugs are in the polypharmacy though not nearly like Gabatril.

Besides more somnolescence and the usual such things that accompany more soporific agents, Lyrica has about a 10% side effect of blurred vision. Extreme rare cases cause other eye related disorders.

So, I enter the brave new world of Lyrica. We're going very slowly as it is uncharted territory psychiatrically at large, at the moment. I'm not near any therapeutic dose, just at a test range at the moment. If it has any benefits and I dont have much eye issues than maybe I can reduce the other GABA agents in my profile.

So that's basically the two in a nutshell

Cheers

-- Jay

 

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