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Lyrica Addiction

Posted on July 10, 2013 in Prescription Drug Addiction

Lyrica AddictionLyrica is like the sports car that does zero to 80 miles an hour in just a few seconds. Lyrica has only been on the market a relatively short time, but by 2013, it was ranking 19th among all prescription drugs, earning more than $3 billion a year for its manufacturer (Pfizer).

The reasons for Lyrica’s dramatic rise is due to the number of people suffering from fibromyalgia and diabetes. About 27 million Americans, or over eight percent of the population, have diabetes, and approximately half of them suffer from nerve pain. Lyrica is a remedy for diabetic nerve pain. Another ten million Americans are suffering from fibromyalgia, a mysterious and painful condition without any recognized treatment. Lyrica became the first drug to be advertised on television as a remedy for fibromyalgia. Just having a drug — any drug whatsoever– for a condition that causes millions of people to limit their lives and is not even recognized by many of their doctors meant that Lyrica would become a blockbuster drug for Pfizer. That’s exactly what happened.

Zero to 80 in four seconds.

What is Lyrica?

Dr. Richard Bruce Silverman discovered pregabalin, the active ingredient in Lyrica, at Northwestern University. Pregabalin is an anti-seizure drug, and no one is exactly sure how it works. Its manufacturer, Pfizer pharmaceutical company, had hoped it would be approved for epilepsy, but it was only effective for partial seizure disorders.

Lyrica binds to alpha2 delta auxiliary subunits of voltage-gated calcium channels, but it does not bind to GABA receptors or affect the reuptake of serotonin, dopamine or noradrenalin in the brain. The drug slows down impulses in the brain and affects the chemicals that send pain signals across the nervous system.

In a chemical sense, pregabalin is an alpha-2-delta ligand that is believed to work by calming hyper-excited neurons.

Many people say that Lyrica “feels” like diazepam (Valium), although the two drugs are not in the same family. Valium is a benzodiazepine prescribed for anxiety that can produce a “mellow” feeling that “all’s right with the world.” Lyrica can produce a similar effect, as well as euphoric feelings for between four and 12% of the people who use it. This makes it habit-forming. The U.S. federal government classifies Lyrica as a Schedule V Controlled Substance or one that is addictive, but has some medical uses and is available legally only by prescription.

What are the Medical Uses of Lyrica?

Lyrica is prescribed to treat partial seizure disorders. Although it is not a typical painkiller, it is prescribed for pain due to fibromyalgia, pain caused by nerve damage in people with diabetes (diabetic neuropathy), pain from the shingles virus (post-herpetic neuralgia), and pain from spinal cord injuries. Doctors prescribe Lyrica “off-label” for other kinds of chronic pain, migraine headaches, pain after surgery, and generalized anxiety disorder.

The United States Food and Drug Administration (FDA) has not approved Lyrica for generalized anxiety disorder in the United States, but the European Commission approved it for that purpose in 2006. Some European authorities believe that Lyrica is preferable to benzodiazepines for anxiety disorders because it does not disrupt sleep. Lyrica has been tested as a treatment for tremors, such as the ones caused by Parkinson’s disease, and it is under study for Irritable Bowel Syndrome.

Lyrica controls but does not cure these conditions.

Lyrica comes as hard gel tablets or in solution form. The typical dosage for diabetic pain is 50mg three times a day; for epilepsy is 75mg twice a day or 50mg three times a day up to 600mg a day; for fibromyalgia, it is 75mg twice a day up to 450mg daily; for spinal cord injuries and nerve pain, it is 75mg to 150mg twice a day up to 600mg per day.

How Effective is Lyrica?

The FDA approved Lyrica on the basis of several studies lasting only a few months. One involved 337 patients and the other 146 patients with diabetic pain. These people received either Lyrica or placebos twice a day for five or eight weeks. People who took the higher doses of Lyrica experienced pain relief up to 50% or more, although some on the placebo experienced pain relief too.

One study was conducted in 2012, and involved of 441 people with fibromyalgia. Some of them took Lyrica for their pain, and others took a dummy pill. Only 121 said their pain was reduced by at least half, and only this group continued to the next phase of this study (even the ones who were helped by a dummy pill). They took either Lyrica or the dummy pill for another three months and then stopped. Fifty-four percent of the people on Lyrica said all their original pain returned, compared to 71% on the placebo. Lyrica stopped working within 58 days compared to 22 days for the people on the dummy pill. What this means is that by the end of the study, Lyrica worked for about two months for 31 of the 220 (13%) people who tried it.

Between two and four percent of Americans or approximately ten million people have fibromyalgia, and report suffering from aches and pains that can be so debilitating that they cannot lead normal lives, and yet many doctors do not even recognized fibromyalgia as a disease. When Pfizer began to advertise Lyrica as a remedy for pain from fibromyalgia, for the first time millions of people felt as if their complaints of vague, widespread chronic pain were finally being addressed.

The American College of Rheumatology, the FDA and certain insurance companies do recognize fibromyalgia, but even Dr. Frederick Wolfe, the person who discovered the disease, is no longer sure it exists. He now believes fibromyalgia is a physical response to stress, depression, and economic and social anxiety. Dr. Nortin Hadler, a professor of medicine at the University of North Carolina, notes that there are no biological tests for fibromyalgia. He told the New York Times that “these people live under a cloud, the more they are around the medical establishment, the sicker they get.” He and others say that patients with fibromyalgia tend to try any number of remedies, but nothing usually works for them.
On the other hand, others believe that Lyrica could be a breakthrough drug for people with fibromyalgia. Dr. Dan Clauw, a professor of medicine at the University of Michigan, told the New York Times, “What’s going to happen with fibromyalgia is the exact thing that happened to depression with Prozac. These are legitimate problems that need treatment.”Dr. Wolfe says that “drug companies will make a fortune as people with fibromyalgia cycle through various sleep, pain and anti-depression medications.”

What Are the Side Effects of Lyrica?

At first the FDA did not want to approve Lyrica because of its side effects, with one of the most troublesome being weight gain. In 12-week trials of the drug, nine percent of patients gained seven percent or more of their body weight, and this is a problem, especially for fibromyalgia patients who weigh an average of 180 pounds within a 5 feet 4 inch frame. Lyrica can also cause edema, fluid retention and swelling.

Other side effects can be depression, suicidal thinking, blurred or double vision, clumsiness, unsteadiness, dizziness, drowsiness, easy bruising, dry mouth, tremors, swelling of the breasts, swelling of the arms, hands, feet and ankles, high or elevated mood, speech problems, constipation, gas, and twitching muscles.

If you have any of the following serious side effects, you should stop taking Lyrica and contact your doctor. These include chills, fast heartbeat, diarrhea, sore throat, ulcers in the mouth, muscle pain, coughing, and difficulty breathing.

What Are the Risks of Taking Lyrica?

One risk of taking Lyrica is that you can become addicted to it and feel compelled to keep taking it even after it stops working for you. You will undergo a withdrawal syndrome when you stop taking it, and you may develop cravings for it and drug-seeking behaviors.

Some studies have shown that one in 500 patients experience mental symptoms such as suicidal thoughts, unusual behaviors, panic attacks, mania, preoccupation with death, withdrawal from friends and normal activities, and aggression. Lyrica has been shown to decrease fertility in male laboratory animals and cause birth effects.

A few people will have an allergic reaction the first time they take Lyrica, and they should seek immediate medical attention for symptoms such as hives, rashes, itching, blisters, blurred vision, shortness of breath, wheezing, muscle pain, and chest pain.

Who Should Not Take Lyrica?

The website with official information from the FDA indicates that people with diabetes should not take Lyrica, even though the FDA approved the drug for treatment of diabetic nerve pain. Lyrica is associated with sores and other skin problems when taken by diabetics. Lyrica should not be taken by people with kidney diseases or bleeding disorders, or histories of drug addiction and alcoholism. If you have had a severe allergic reaction to similar medications, you should not take Lyrica.

You should not take Lyrica if you have angioedema, congestive heart failure, depression, edema, heart rhythm problems, or low levels of platelets in your blood. Lyrica has not been studied adequately as a treatment for children. Patients over 65 years old can use Lyrica with caution because it increases their risk for confusion and falls.

Pregnant and breast-feeding women should not take Lyrica because it may pose a danger to their children. Men who intend to father children should not take Lyrica because this drug increases the chances of their children having certain birth defects.

What Drugs Interact with Lyrica?

Do not use Lyrica with alcohol or street drugs. Do not combine it with drugs that slow down the central nervous system, which are most often drugs that cause drowsiness such as anti-histamines, antidepressants, tranquilizers, sedatives, sleeping pills, prescription narcotic pain killers, muscle relaxants, barbiturates, cold and allergy medicines, and anesthetics, even the ones for dental surgery. Do not take Lyrica with angiotensin-converting enzyme (ACE) inhibitors or naproxen.

Although it is prescribed for diabetic nerve pain, Lyrica interacts with certain medications for diabetes.

Does Lyrica Show Up on Urine Tests?

In the past, Lyrica did not show up in routine urine tests at work or school. Most urine tests screen only for narcotics, marijuana, LSD, PCP, amphetamines, barbiturates, and benzodiazepines. However, Lyrica can now be detected on certain newer and more sophisticated test kits from laboratories like ARUP and AIT. If you have a prescription for it, you should be all right.

What is Lyrica Overdose?

Taking too much Lyrica is rarely fatal. One person ingested 8000mg of Lyrica and survived. Symptoms of a Lyrica overdose can be mood changes, fatigue, confusion, depression, agitation and restlessness.

Since Lyrica is such a new drug, little is known about how to treat overdoses. There are no antidotes to counteract the drug. The usual emergency medical treatment for Lyrica overdoses is to “pump the stomach,” administer charcoal, open up the airways, and induce vomiting.

What is Lyrica Withdrawal?

Lyrica can cause an unpleasant withdrawal syndrome when you stop taking it. If you have been taking Lyrica for seizures, your seizures could come back more frequently when you stop taking it.

Other symptoms can be headaches, seizures, nausea, dizziness, diarrhea, vomiting, irritability, insomnia, nightmares, and tingling sensations.

How Can I Stop Taking Lyrica?

Lyrica may stop working for you within a few months, but you may find it hard to stop taking it because it is habit-forming and can cause physical dependency, even though its addictive potential is not nearly as great as drugs like alcohol or cocaine. In laboratory studies, rats will keep pulling letters to secure cocaine all day long, but they only seek out Lyrica on an intermittent basis. In studies of people, between four and twelve percent feel euphoric after taking Lyrica, which means it could be particularly addictive for certain people, perhaps for genetic reasons.

Very little is known about Lyrica withdrawal because it is not been on the market for very long. One danger is that if you have been taking Lyrica for a seizure disorder, your seizures may return a greater frequency.
You may want to consult your family physician for help. Addiction specialists at residential treatment centers for drug addiction have the most knowledge and expertise in helping people wean themselves from all kinds of drugs and to teach them non-pharmaceutical methods of dealing with pain and anxiety. One course of action may be to consult the experts at a residential center for drug addiction. They will know how to make you comfortable during your withdrawal from Lyrica, and they can show you new ways of dealing with stress and tension without drugs.

What Are the Signs I Am Abusing Lyrica?

If you can answer yes to any of these questions, you may want to consider talking to your family physician or an addiction specialist at a residential treatment center about your concerns with Lyrica.

• Do you believe that Lyrica has stopped relieving your pain?
• Do you experience withdrawal symptoms when you stop taking Lyrica?
• Have you tried to quit taking Lyrica on your own but failed?
• Do you have a history of drug or alcohol alcoholism?
• Do you use Lyrica along with alcohol or other drugs as a way of treating emotional pain?
• Are you taking Lyrica even though you experience unpleasant side effects and even though you are unsure if it is effective for you?
• If money were no object, would you enter an intense program to help you deal with chronic pain, using non-pharmaceutical interventions?

References:

“U.S. Pharmaceutical Sales2013,” The United States Food and Drug Administration, see http://www.drugs.com/stats/top100/2013/q1/sales
“Lyrica Makes Rain on Northwestern University,” August 27, 2007, Wall Street Journal.
“Pregabalin Trials and Studies,” Center Watch, see http://www.centerwatch.com/drug-information/fda-approvals/drug-details.aspx?DrugID=900
“Pregabalin (Oral Route,)” The Staff of the Mayo Clinic, see http://www.mayoclinic.com/health/drug-information/DR601627
“Lyrica Approved for GAD in Europe,” Medical News Today, March 28,2006, see http://www.medicalnewstoday.com/releases/40404.php
“Lyrica,” The RX List, see http://www.rxlist.com/lyrica-drug.htm
“Valium,” the RX List, see http://www.rxlist.com/valium-drug.htm
“Pregabalin Trials and Studies,” Center Watch, see http://www.centerwatch.com/drug-information/fda-approvals/drug-details.aspx?DrugID=900
“Drug Scheduling Actions 2005,” The United States Drug Enforcement Agency, see http://www.deadiversion.usdoj.gov/fed_regs/rules/2005/fr0728.htm
“Post Herpetic Neuralgia,” The Staff of the Mayo Clinic, see http://www.mayoclinic.com/health/postherpetic-neuralgia/DS00277
“Lyrica,” Official Information from the United States Food and Drug Administration, Drugs.com, see http://www.drugs.com/lyrica.html
“Lyrica Approved for GAD in Europe,” Medical News Today, March 28,2006, see http://www.medicalnewstoday.com/releases/40404.php
Zesiewicz TA, Ward CL, Hauser RA, Salemi JL, Siraj S, Wilson MC, Sullivan KL. A pilot, double-blind, placebo-controlled trial of pregabalin (Lyrica) in the treatment of essential tremor. Movement Disorders, 2007 Aug 15; 22(11):1660-3.
“A Placebo-Controlled Trial of Pregabalin for Irritable Bowel Syndrome,” The Mayo Clinic, see http://www.mayo.edu/research/clinical-trials/CTS-00102896
“Pregabalin,” The United States Library of Medicine, The National Institutes of Health, Medline, see http://www.nlm.nih.gov/medlineplus/druginfo/meds/a605045.html
“Lyrica,” The RX List, see http://www.rxlist.com/lyrica-drug.htm
“Pregabalin (Oral Route,)” The Staff of the Mayo Clinic, see http://www.mayoclinic.com/health/drug-information/DR601627
“Pregabalin Trials and Studies,” Center Watch, see http://www.centerwatch.com/drug-information/fda-approvals/drug-details.aspx?DrugID=900
“Pfizer: Pain drug Lyrica better than placebo,” USA Today, November 19, 2012; and
Grogan, Kevin. Pfizer’s Lyrica CR shows promise in fibromyalgia study, Pharma Times, November 20, 2012, seehttp://www.pharmatimes.com/Article/12-11-20/Pfizer_s_Lyrica_CR_shows_promise_in_fibromyalgia_study.aspx
Berenson, Alex. “Drug Approved. Is Disease Real?” The New York Times, January 14, 2008.
Ibid.
Ibid.
“Pregabalin (Oral Route,)” The Staff of the Mayo Clinic, see http://www.mayoclinic.com/health/drug-information/DR601627
“Lyrica,” Official Information from the United States Food and Drug Administration, Drugs.com, see http://www.drugs.com/lyrica.html
“Pregabalin,” The United States Library of Medicine, The National Institutes of Health, Medline, see http://www.nlm.nih.gov/medlineplus/druginfo/meds/a605045.html
“Pregabalin (Oral Route,)” The Staff of the Mayo Clinic, see http://www.mayoclinic.com/health/drug-information/DR601627
“Pregabalin,” The United States Library of Medicine, The National Institutes of Health, Medline, see http://www.nlm.nih.gov/medlineplus/druginfo/meds/a605045.html
Ibid.
“Lyrica,” Official Information from the United States Food and Drug Administration, Drugs.com, see http://www.drugs.com/lyrica.html
“Pregabalin (Oral Route,)” The Staff of the Mayo Clinic, see http://www.mayoclinic.com/health/drug-information/DR601627
“Pregabalin (Oral Route,)” The Staff of the Mayo Clinic, see http://www.mayoclinic.com/health/drug-information/DR601627
“Lyrica,” Official Information from the United States Food and Drug Administration, Drugs.com, see http://www.drugs.com/lyrica.html
“Pregabalin (Oral Route,)” The Staff of the Mayo Clinic, see http://www.mayoclinic.com/health/drug-information/DR601627
“Lyrica Drug Interactions and Indications,” The RX List, see http://www.rxlist.com/lyrica-drug/indications-dosage.htm
“Lyrica Overdoses,” The RX List, http://www.rxlist.com/lyrica-drug/overdosage-contraindications.htm
“Side Effects of Stopping Lyrica,” Livestrong.com, see http://www.livestrong.com/article/70712-side-effects-stopping-lyrica/
“Pregabalin (Oral Route,)” The Staff of the Mayo Clinic, see http://www.mayoclinic.com/health/drug-information/DR601627
“F.D.A. Approves Pfizer Remedy for Nerve Pain From Diabetes,” Bloomberg News,
January 1, 2005.
“Pregabalin Trials and Studies,” Center Watch, see http://www.centerwatch.com/drug-information/fda-approvals/drug-details.aspx?DrugID=900

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