What is Lyrica?
Lyrica, also known as pregabalin, is a drug made for the treatment of seizures in epilepsy. This drug is made to work by restricting nerve impulses that induce seizures. It can also inhibit pain by suppressing pain signal transmissions by the nerves.
Other uses for Lyrica include:
- Alleviating fibromyalgia
- Relieving pain resulting from nerve damage in people with diabetes, herpes zoster, or spinal cord injury.
Much of Lyrica use is in off-label treatment procedures.
How does Lyrica work?
Pain experienced by people who have neuropathy and fibromyalgia is considerably amplified. Pain arises from the nerve changes that take place, making them more sensitive to pain reception and transmission. How this drug relieves fibromyalgia pain is still in a grey area. However, it has been seen among several patients that after taking Lyrica, they become more comfortable. Lyrica works for both fibromyalgia and neuropathy.
Lyrica is used for the treatment of the following conditions:
- Neuropathy-related pain or nerve damage in several parts of the body.
- Nerve damage due to shingles.
- Terminal pain from fibromyalgia and other related symptoms.
- Nerve damage from an injured spine.
- Used alongside with other medications to relieve seizures.
This drug is reported to have a better end point and can also be used to treat restless legs syndrome (RLS).
- Lyrica can only relieve pain and does not cure the cause of pain. Some people may require longer periods of treatment before experiencing its effects.
- Some fatal complications may arise from the use of Lyrica.
- This drug can disorient your mental status, developing suicidal tendencies in some people.
- People with diabetes should constantly monitor their skin for the development of sores. If you notice any skin abnormalities after taking Lyrica, notify your doctor right away.
- Lyrica can cause more fluid to accumulate in the lower limbs.
Inform your doctor if you had the following conditions:
- Inflammation of the eyes, lips, face, or throat
- Vision-related complications
- Blood disorders or diseases
- Diseases of the kidney
- Mental disorders such as depression
- Any planned or recent surgery including dental operations
Before Taking This Medicine
If you have an allergy towards pregabalin, don’t use Lyrica. For safety reasons, people who have any of the following conditions should prohibit its use:
- Congestive heart failure
- If you are diabetic, unless you use Lyrica to cure diabetic neuropathy
- Bleeding complications and other blood-related disorders
- If you ever had suicidal behaviors or depression
- If you ever had an alcohol addiction or other types of drug abuse
- If you develop severe allergic responses
Suicidal thoughts are very common while taking this medication. Thus, it is important for people who are taking Lyrica to be kept under their doctor’s guidance. Moreover, make sure to keep track of any unusual mood changes during the initial stages of treatment or when the dose is altered.
Any set appointments to your doctor should be met promptly to properly assess your recovery and to ensure everything is on the right track.
Lyrica in Pregnancy and Breastfeeding
The effect of Lyrica to an unborn baby is still unclear. It is important to note that Lyrica should only be prescribed in pregnant women when there are no other alternative medications available and when the benefits of taking Lyrica outweigh the risks involved. Lyrica can be excreted in the mother's milk while breastfeeding, but the effects on the nursing baby are still unknown. You can take Lyrica while breastfeeding but must be according to your doctor's assessment and recommendation. However, an alternative drug may be prescribed, especially when you are nursing a newborn or a premature baby. The dose must not be modified without consulting your doctor first.
What is neuropathy?
Neuropathy is the result of peripheral nerve damage that causes numbness, pain, or weakness in your upper or lower limbs. Aside from your hands and feet, peripheral neuropathy can also affect your face, mouth, and internal organs.
The peripheral nervous system relays important impulses required for physical sensations. Damage in the nervous system due to injury or other causes can result in peripheral neuropathy. Such conditions can cause abnormal functioning of the nerves. Nerve malfunctioning may also due to:
- Certain diseases or illnesses
- Inherited or congenital disorders
These disorders can be overwhelming. Nonetheless, treatment is available and can give much relief. It is quite important to know the root cause of peripheral neuropathy to understand your condition better.
Common Symptoms of Peripheral Neuropathy
Peripheral nerves are divided into:
- Sensory nerves that give sensations.
- Motor nerves that are responsible for physical movements.
- Autonomic nerves that reach the internal organs.
Peripheral neuropathy can affect a single nerve cell or all classes of nerves. The following are details of the warning signs of peripheral neuropathy:
- Itchiness or tickling sensations in the limbs
- Feeling like you have put on tight gloves or socks
- Intense stabbing pain
- Loss of sensation in the limbs
- Feeling as if your arms or legs are stuck in one anatomical position
- Loss of grip that can regularly cause you to drop things
- A humming and throbbing sensation
- Reduced blood pressure
- Sexual malfunction (affects more men than women)
- Costiveness and constipation
- Difficulties in digestion
- Loose bowels
- Profuse sweating
A comprehensive examination should be done as most of these symptoms overlap with those of other complications or diseases.
Causes of Peripheral Neuropathy
Instances of peripheral neuropathy are more common if there were other previous cases reported in your family history. Some other causes of peripheral neuropathy may also be in play, which includes:
1) Generalized Diseases
Diabetes is the most diagnosed cause of peripheral neuropathy. After its development, there is numbness and a loss of sensation in the limbs. Peripheral neuropathy is more frequent in the following individuals:
- Overweight or obese
- People with high blood pressure
- 40 years old and above
- People with diabetes
From a study done by the University of Chicago’s Center for Peripheral Neuropathy (UCCPN), most people who have diabetes have an undiagnosed nerve damage due to the high levels of sugar in their blood.
There are other terminal illnesses that can cause nerve damage. They include:
- Kidney disorders - where toxins build up, thereby damaging nerve tissues.
- Underactive thyroid (hypothyroidism) - a decreased production of the thyroid hormone can cause fluid retention, increasing the pressure on the nerve tissues.
- Illnesses - that result in severe inflammation can also affect the nerve tissues, interfering with the proper transmission of impulses.
- Vitamin deficiencies - if there is a deficiency in vitamins E, B1, B6, and B12, the proper functioning of the nerve cells is impaired.
Severe trauma is one of the most common causes of nerve damage. Trauma can be in the form of accidents, fractures, or even remaining still in one position for an extended period of time. Carpal tunnel syndrome is a good example of peripheral neuropathy. This disorder is caused when the carpal tunnel is crushed or compressed resulting in damage to the median nerve.
3) Toxins and Alcohol
People who drink regularly have higher risks of developing peripheral neuropathy since alcohol damages nerve tissues.
Damage to the nerves can also happen when specific toxic chemicals such as glue and other solvents are introduced into the body. Additionally, heavy metals and lead are also common causes of nerve damage.
4) Infections and Autoimmune Disorders
Some strains of viruses mainly affect the nerves. The herpes simplex and varicella zoster virus alongside the Epstein-Barr virus are known to damage the sensory branch of the nerves and can cause excruciating pain.
Some bacterial infections, if left untreated, can end up in nerve damage. People with HIV and AIDS, or Lyme disease will probably develop peripheral neuropathy within their lifetime.
Immune disorders including rheumatoid arthritis can influence the peripheral nervous system in many ways. Chronic inflammation in the body can cause a buildup of pressure around the neurons, causing damage and severe pain.
There are some prescribed medications that can cause nerve damage. They include:
- Anticonvulsants or anti-epileptic drugs
- Antibacterial medications
- Drugs prescribed to normalize high blood pressure
- Cancer therapy medication
- Drugs that are used to lower the levels of cholesterol in the body
- Medications that prevent cardiovascular diseases
Diagnosis of Peripheral Neuropathy
The doctor will take your medical history and conduct a general physical evaluation. If the doctor cannot come up with a diagnosis based on the initial assessments, the following tests may be done:
- Blood tests to determine vitamin and blood sugar levels.
- Thyroid function tests to check if the thyroid is still functioning properly.
- A CT or MRI scan to see if there is something that causes pressure to the nerves such as a herniated disk or tumor.
- A nerve biopsy so that the surgically removed nerve tissue can be closely examined under a microscope.
This test can be done to show if there are any issues in relaying impulses. A tiny needle is inserted into the muscle. The patient is then instructed to make gentle movements. Sensors within the needle will weigh the amount of electricity that resulted from your actions. The test feels like an injection and it is completely normal to feel sore days after the test was done.
Nerve Conduction Study
In this test, electrodes are placed on your skin. These electrodes will detect any electricity generated from physical activity to assess if the transmission of nerve impulses is efficient. Most people feel uncomfortable during the test. However, the pain disappears when the test is done.
Preventing Home Accidents and Injuries
Having peripheral neuropathy makes you more susceptible to severe injuries at home. The following measures can be adopted to safeguard you against accidents:
- Wear suitable shoes that can protect your feet.
- Get rid of the things that can make you slip or fall down.
- The temperature of your bathwater should be tested using your elbow, hand, or foot.
- Equip your bathtub with handrails.
- To avoid slipping, use non-slip bath mats.
- Be mobile. Avoid being in a single position for too long, especially if you sit for long periods of time. Get up and walk around for a few minutes after certain intervals.
Handling Neuropathy by Adopting a Healthy Lifestyle
People who have neuropathy can live a healthy life by:
- Regularly exercising to improve muscle tone and to reduce the frequency of cramps.
- Consuming a healthy diet that can tackle nutritional deficiencies and most problems in the gut.
- Putting a stop to smoking since it can impair the proper circulation of blood and induce some neuropathic symptoms.
- Being active and not sedentary, which can increase the pressure on the joints and other parts of the body.
- Rubbing the affected areas including the legs and feet or other affected parts of the body to invigorate nerves and increase blood circulation.
For people who have peripheral neuropathy, their sensation is altered by feeling pain or numbness, particularly in the feet.
Due to the effects of peripheral neuropathy, people who have diabetes are highly encouraged to constantly monitor their symptoms and check both of their legs and feet from time to time for any cuts, unusual rashes, or sores.
It is also recommended to wear shoes with soft socks to reduce the possibility of having sores on the feet.
Lyrica for Neuropathy
Pregabalin or Lyrica® is approved by the FDA for the treatment of pain caused by postherpetic neuralgia, diabetes, or fibromyalgia. It is also prescribed for seizures. The mode of action of Lyrica is by clinging to a subunit of a voltage-gated channel in the brain or spinal cord. This inhibits the entry of depolarization-induced calcium into neurons, thereby minimizing the release of neurotransmitters by the neuron.
Lyrica can treat diverse types of neuropathic pain. The response to this treatment is similar to duloxetine. About 66 percent of patients have a positive response. The rate of response in postherpetic neuralgia shows that it is more difficult to treat. The fact that Lyrica is not combined and does not interfere with other drugs makes its use much simpler. Swelling and exhaustion in the lower limbs are the most reported secondary signs. In other people, there may be a slight increase in their weight.
The first drug approved by the FDA for treating fibromyalgia was Lyrica. Study methods were unusual and the number of patients who agreed to its use was small. The same study showed that some patients felt fatigued after taking the drug. Nonetheless, Lyrica is widely used and it has been helpful for many years in treating fibromyalgia.
How Lyrica Treats Neuropathy
Lyrica is effective since it causes people with neuropathy to work more efficiently. The drug also reduces pain and improves one's sleep. In one study, some patients even felt its pain-relieving effects after taking it for only a week.
Lyrica Dosage for Neuropathy
1) Neuropathic pain in diabetes-induced peripheral neuropathy
The recommended maximum dosage in persons having a creatinine clearance of at least 60 mL per minute is 300 mg/day. Based on how well you respond to treatment, the lowest dose of 150 mg/day may be increased to 300 mg within the same week. The dosage of Lyrica should be controlled in patients with reduced renal function since the drug is eliminated through the kidneys.
Lyrica was also studied at 600 mg/day. This dose, however, is not commonly prescribed, since there is no evidence whether it has an added advantage or if it is less adaptable. Dosages above 300 mg in a single day are not prescribed due to dose-dependent adverse reactions.
2) Neuropathic pain due to spinal cord injury
The recommended dose for such condition is 150-600 mg/day. The starting dose is 150 mg/day, which can then be compounded up to 600 mg/day within a week based on how efficient and tolerant you are to Lyrica. For patients who feel the same after being put under medication, the dose can be doubled up to 600 mg/day within two days of the initial dose. The dose should be controlled for patients with impaired renal function.
Preventive Measures Against Neuropathy
If neuropathy is a common feat in your family, you can prevent it by:
- Reducing your alcohol consumption
- Quit smoking
- Adopting a healthy diet
- Keeping fit
The risk of developing peripheral neuropathy can be avoided by:
- Identifying the toxins you are regularly exposed to
- Protecting your feet from injuries
- Preventing the inhalation of toxins
- Being careful not to injure one's skin, especially for people who have diabetes
Lyrica for Diabetic Neuropathy
Diabetic nerve pain (diabetic peripheral neuropathy) is a common occurrence. Since diabetes is associated with elevated levels of sugar in the blood, there can be an irreversible damage to the nerves causing unbearable pain.
To get optimum results, the two most important things to do when taking Lyrica is to work hand in hand with your doctor and to constantly monitor your progress. These practices are vital, especially if the pain you are experiencing is not easily relieved.
The best dose is 300 mg/day. However, the doctor still needs to come up with the most suitable dose after assessing your recovery and tolerance to the drug. Kidney malfunction may require greater dose adjustments.
Lyrica Side Effects
Seek emergency medical services if you develop any of the following:
- Allergic response to Lyrica
- Worsening symptoms or other abnormal symptoms you never had before taking the drug
- Vision problems
- Bruising and bleeding easily
- Muscle pain, exhaustion, and sensitivity to touch
- Breast swelling
- Dry mouth
- Poor mental coordination
The Long-Term Outlook
It is important to treat the cause of neuropathy and to relieve its accompanying symptoms. If Lyrica is not for you, speak with your doctor to find other alternatives that can improve your condition.