Posted by Larry Hoover on February 22, 2006, at 8:50:07
In reply to Lyrica and Fibromyalgia, posted by Lonely on February 22, 2006, at 0:24:26
> I've signed up to take part in a study on treating fibromyalgia with Lyrica. Don't know if I'll get in or finish it but am thinking ahead.
Also consider that you might get placeboed. Free meds is great, but the med might be candy.
> I'm a little uneasy ... I'm the originally "reactor" to meds and the thought of taking a drug that was developed for epilepsy bothors me.
It wasn't originally developed for epilepsy, though. It was developed because of its high affinity for the alpha adrenergic delta 2 receptor (if I recall correctly, off the top of my head, before my coffee has hit my brain).
> I'm afraid of it getting something started that won't end or will cause some other damage. On the other hand, I'd like to have less pain although I think a lot of it is arthritis. I was diagnosed by a rheumatologist about 4 years ago with mild fibromyalgia.
>
> I was wondering if others have taken Lyrica?I've been on in for about five months now.
> What was the experience?
It was supposed to be nearly free of side effects. Ha!
First things first. It did reduce my pain. I have a neuropathy akin to causalgia, which gives me constant hyperalgesia (excess pain stimulus in response to painful stimuli), allodynia (non-pain stimulus felt as pain), overlaid upon a bed of constant ache/ringing pain, like a bell has been rung in my arm. Only the bell is ringing crushing pain. I'm on other meds as well, as you can imagine, so my experience with Lyrica may also be influenced by drug interactions.
I'm going to have trouble recalling the initial side effects, because one of the side effects has been impaired short-term memory. And if short-term memory fails, long-term memories do, too. It's all kind of blurry. I bet I posted about those side effects, and I'll see if I can pull them up, later. <couldn't find them, using the search feature>
First thing was that the "treble" notes of the pain dropped out. It hurt just as loudly, but the pain was all bass now. Actually, that was an improvement. Also, the pain had been gradually getting worse, but this seemed to stabilize it. It stopped getting worse, but hasn't really gotten better. That may be a characteristic of my neuropathy, though.
General adverse effects included dizziness, constipation and urinary hesitation, but that may be an additive effect with the other meds. I also had trouble sleeping any time I took a dose close to bedtime.
I've had two significant and persistent cognitive/sensory adverse effects. I think my night vision is reduced. I try not to drive at night, now. And the other thing is more difficult to describe. I found that I had to "work" my mouth, to be able to speak. I had to consciously move my mouth, and shape the words so that they would be intelligible. That made it much more difficult to communicate anything complex, because my thinking was already tied up working my mouth. I also had a similar experience physically, some times. I've always had great reflexes, but now I'm more sluggish and clumsy.
> I know that other drugs developed for epilepsy are used as mood stabilizers for bipolar disorder although I haven't seen Lyrica in that category. It seems like someplace I read that it has anti-anxiety effects but also causes dizziness and sleepiness. That would not work for me! I'm not bipolar and do not take any psychiatric meds other than a Tranxene maybe 3 to 6 times a month.
I don't think the drug has been around long enough for the true side effect pattern to be clearly laid out.
Here's a link to the drug monograph. It's a .pdf (Adobe Acrobat) file. http://www.pfizer.ca/english/our%20products/prescription%20pharmaceuticals/default.asp?s=1&id=25&doc=enmonograph
When I added in a sixth drug (medical cannabis) on top of Lyrica (the fifth drug in my current cocktail), many of the side effects diminished or disappeared completely. That's a reason why I'm struggling with my recollection of what it had been like to use the drug.
> How does Lyrica work? And, how does it affect fibroymyalgia? Does it just block the pathways to prevent the pain sensation?
Not exactly. It doesn't block the pain sensations. It's supposed to bind to special receptors at the spinal cord that cause the pain to persist.
> If that's the case, then isn't it a bit dangerous?
It doesn't block pain in the sense that you won't feel pain if you hurt yourself. If you, for example, get your finger stuck in a door, you're going to feel that sharp crushing pain. That pain signal is transferred from the peripheral nervous system to the central nervous system at the spinal cord. From there, the signal splits. One part goes straight up to the brain. That's where the pain is "felt". The other part goes back down your arm and causes you to flinch. By splitting the signal, your reflex to withdraw your hand is quicker than it might have been if the signal had to go all the way to the brain, and then return back outwards to your arm. You're flinching at the same time your brain is realizing you're in pain.
It's that splitting and crossover thing that has gone wrong in my arm, and is likely/possibly going wrong in fibromyalgia. The feedback from the spinal cord also sets up the peripheral nerve for the long-standing achiness that can follow an injury. It sensitizes the surrounding nerves, so that you're going to protect the injured flesh. That sensitizing process can "lock in", so that there is pain and tenderness long after the injury has healed. In my own situation, it has gone to an absurd level. The theory is that this is also occurring in fibromyalgia. If you could function pain-free, you'd probably function much better, eh?
The pain each of us has is real. The pain each of us has limits our functioning. But there's no medical reason for the pain to exist. The nerve(s) has malfunctioned.
> Why not treat what's causing the pain? The research rep told me they've had excellent responses to it in terms of reducing pain. It's not approved now for fibroymyalgia.
They've never discovered what causes the pain of fibromyalgia. Nor have they discovered what causes pain like mine. They're trying to disrupt the signalling system in such a way that it still works (you'll still feel pain if you hurt yourself), but the chronic nagging pain is gone.
> Thanks for reading my ramblings - appreciate any responses.
I hope I haven't confused the issue for you. Questions welcome.
Lar
poster:Larry Hoover
thread:611969
URL: http://www.dr-bob.org/babble/health/20060202/msgs/612010.html