FROM OUR EXPERTS
Recently I wrote about the anti-seizure medication, Topamax, for chronic headache pain. Today, I would like to discuss another medication which has also been used to treat seizures: Lyrica. This has been on the market for less than a year, but I have found it a very helpful drug in patients with chronic pain syndromes, such as fibromyalgia. Fibromyalgia occurs predominantly in women of child-bearing age, and is seen commonly in the offices of most rheumatologists in the United States. Afflicted patients usually complain of diffuse musculoskeletal pain, poor sleep, and fatigue. Often, the amount of pain is related to the amount of sleep—the less sleep, the more pain. Many patients feel their pain is worsened by stress, cold weather, or overexertion. Conversely, patients will feel better in warm weather, while on vacation and away from the usual worries of day to day living, and with improved sleep hygiene. Patients will often suffer from chronic headaches and an irritable bowel.
A new study published in the October 2012 issue of Pain Medicine investigated the burden of illness and treatment patterns in 1,700 patients with fibromyalgia from July 2008 through May 2010 in 58 care settings in the U.S. and Puerto Rico.
Despite the fact that only three drugs have received FDA approval for the treatment of FM ( Lyrica , Cymbalta and Savella ), investigators discovered that the patients in the study were taking 182 different prescription medications and using 17 nonpharmacologic treatments.
The top 11 drugs or drug classes being prescribed included:
Cymbalta (duloxetine) – 26.8%
Nonsteroidal anti-inflammatory drugs (NSAIDs) – 26.6%
Lyrica (pregabalin) – 24.5%
Opioids – 24.2%
Ultram (tramadol) – 15.3%
Benzodiazepines – 15.2%
Selective serotonin reuptake inhibitors (SSRIs) – 13.1%
Flexaril (cyclobenzaprine) – 12.9%
Nonbenzodiazepine sedative/hypnotics – 12.9%
Neurontin (gabapentin) &nd...
A new study, presented at the 29th Annual Scientific Meeting of the American Pain Society in Baltimore earlier this month, gave doctors one more treatment option to consider for fibromyalgia patients . The study found that FM patients who did not have particularly good results from taking Lyrica alone experienced significantly reduced pain and greater overall improvement when taking Savella in addition to the Lyrica. Since Lyrica is effective for only about one third of FM patients, and since Lyrica and Savella have different mechanisms of action, the researchers wanted to see what happened when they were combined. Study Methods and Results In this study 173 patients were given just Lyrica and 179 were given Lyrica plus Savella for 11 weeks. The dosages used were 150 or 225 mg of Lyrica twice a day and 50 mg of Savella twice a day. By week 11, the pain scores of the Lyrica group dropped four points as measured by the Visual Analog Scale, while the pain scores of t...
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