Lyrica (Pregabalin)

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The Magic of Lyrica (Pregabalin)

by Jon Bernardes, long term Prostatitis Sufferer, Shropshire, United Kingdom.

Diagnosed with Chronic Prostatitis in January 1994, I have lived with pain and discomfort (not to mention more usual prostate symptoms such as urgency, frequency, pain on urinating) for over 11 years. I was a previously fit and healthy middle class professional then in my mid forties. Since 1994, I had not had one single day when pain management wasn't the over-riding issue in my life. As with many chronic pain sufferers, I managed to keep working but gave up any kind of social life, lost fitness and began to look forward to retirement just to end the daily struggle of getting to a (thankfully very flexible) job. The various management strategies involved 4 components: a regular (16 week) caudal block, acupuncture (4-6 weekly), Dothiepin (an anti-depressant which also interacts with acupuncture to relieve pain), and the main daily drug of Coproxamol -- ranging from 2/3 tables on a "˜good day' to the maximum dose of 8 on a "˜bad day'.

With the end of Coproxamol prescribing in sight in the UK, I tried a wide range of other prescription painkillers with my GP's help -- all were far less effective than Coproxamol and some had unpleasant side effects. About to panic (and very depressed) I attended my regular caudal block and discussed the issue with my Pain Consultant who suggested a new drug: Lyrica ( a.k.a Pregabalin - licensed for use on neuropathic pain in July 2004 -- see European Medicines Agency: http://www.emea.eu.int/humandocs/Humans ... Lyrica.htm ; at time of writing the drug is not on UK Pfizer site but the American review can be seen at: http://www.pfizer.com/pfizer/are/invest ... 4_1231.jsp OR
http://www.drugdevelopment-technology.c ... regabalin/ ).

I contacted my very helpful GP and got a prescription -- so my years of pain came to an end -- not simply and immediately but after some experimentation and careful management.

From the very first tablet, I realised that I had simply forgotten what life without pain could be like -- initially, these were only brief periods between a range of side effects --most notably, a distinct dizziness and headaches (the latter probably due to withdrawing the Coproxamol). Initially I tried one 75Mg tablet 12 hourly"¦.the dizziness continued and the pain began to feel like it might return after 6 hours and did return with a vengeance towards 12 hours.

Within a week, I dared to try a cycle ride in the pain free period and found that I managed a mile or two with no ill effects; I repeated this with time and found that such exercise did not seem to lead to pain crises (as it had in the past). To tackle the midday pain, I moved to 75Mg tablets 8 hourly and found this much more effective in terms of continual pain control BUT found myself in a continual haze (not unpleasant but I did not like to drive); the bike riding and exercise developed well and I began to have patches of feeling really well and pain free.

My GP then agreed to prescribe 50Mg tablets and this dose 8 hourly has removed the haze and any dizziness. After nearly three whole months, I am pain free, regularly riding my bike (6 -- 9 miles a day) and have returned to my favourite exercise -- Jogging. I started VERY carefully with one minute jogs but am now up to 60 minutes. My wife and I had a marvellous 2 week holiday in Crete where I swam regularly, walked miles, hiked up and down mountain gorges and generally managed like a perfectly healthy person. I am losing some weight and beginning to feel much healthier and, strangely, some of the prostate symptoms are also abating. Lyrica, however, is not a cure -- if I forget a tablet for a few hours, the familiar nagging pains in perineum, lower abdomen and lower back pop-up BUT taking the tablet and relaxing for an hour or two usually solves the problem.

Strangely, I cannot find much mention of patient experiences with Lyrica on the internet and I am still not really sure what "˜neuropathic pain' is BUT this stuff is simply magic for me and my prostatitis. So far, there are limited side effects -- the dizziness seems to disappear after a while and the drug appears to "˜target' the pain very well. A broken tooth hurt like hell despite my prostate pain being completely absent; previous painkillers (such a Coproxamol) seem to hit your whole system and mask any and all pains; Lyrica seems to just control the long term prostate pain.

I have no idea whether this drug will work for anyone else but do suggest that you talk to your GP and give it a try -- be prepared, though, to take control and experiment with dose strength and period (I am on 3 * 50Mg = 150Mg daily; the maximum is 600 Mg a day so I guess there is room to manoeuvre. The drug comes in 25 mg, 50 mg, 75 mg, 100 mg, 150 mg, 200 mg, or 300 mg capsules so it should be possible for anyone to experiment with dosage until they have good pain control"¦.BEST OF LUCK!

Time and continuing permitting, I will try and respond to any queries to [email protected] but please be patient -- PLEASE provide a subject line including "Lyrica".

[scotsman]

Very interesting post.

Could anyone spread some light on the pros and cons of going for something like this as opposed to Ultram (Tramadol)? Is it simply a case of trying these lines of drugs if Ultram doesn't work for you, or are there other benefits aside from pain relief?

Richard.

[SickofCP]

Maybe it's just me......but I'm always skeptical at hearing stories of men who as soon as they go pain free...jump on a bicycle. I have to say, that if I ever suddenly had an abatement of symptoms, the LAST thing I would do is go on a bike seat. Why press your luck? It seems almost irrational.

[chewymix]

no sure - but on the uk CP yahoo group this drug has been discusses quite a lot recently. Long term sufferrers have tried it after reading positive reports and are also reporting positive outcomes.

Its not a 'cure' though and only masks the pain but apparently it seems to do this very well and also very 'targeted' as opposed to numbing everything.

Another potential drug to help it seems

[dshoskes]

This drug is about to be studied by the CPCRN (NIH prostatitis collaborative group) in a randomized placebo controlled study in men with CPPS.

Our site is expecting approval to start within about 4-6 weeks.

[Ddream]

I know many people who have tried various antiseizure medications for chronic pelvic pain (Neurontin, Topamax, etc.) and the pain reduction lasted only the first several months of use and then it quit working. I hope Lyrica works longer than the first 3 months of use.

If the controlled study on Lyrica only examines the first few months of use, it could give misleading conclusions about its long term efficacy.

[gil_galad]

The same reaction I got (and I have seen it,in others too) with antidepressants (Efexor,Zoloft etc).They work great at first but gradually the loose their effectiviness.

[LightningTree]

Maybe it's just me......but I'm always skeptical at hearing stories of men who as soon as they go pain free...jump on a bicycle. I have to say, that if I ever suddenly had an abatement of symptoms, the LAST thing I would do is go on a bike seat. Why press your luck? It seems almost irrational.

I know. People who love to bike, though, love to bike. My twin brother was an avid mountain biker and has CPPS. He has been largely symptom free for 8 months now, and he stairs longingly at his bicycle hanging in his garage. I keep trying to convince him to sell it. But he dreams of riding again.

Its good to hear that studies are being done on the drug with CPPS. I hope it proves effective. We could use a mitigation strategy that is effective.

[londoner]

Can anyone tell me the difference between Pregabalin and Gabapentin? I'm having some relief from Gabapentin, basically taking it when I need it, most days but not all. The first day I took it I had a massive rant at my boss until I realised I was having bad side-effects and told him to ignore me. The plaster is still falling from the ceiling.

The other thing I was wondering about this type of drug is: by concealing sensation (even unwanted ones) does it prevent you from learning how to relax the pelvic muscles naturally?

[londoner]

The Magic of Lyrica (Pregabalin)

the drug appears to "˜target' the pain very well. A broken tooth hurt like hell despite my prostate pain being completely absent; .

I should point out that shortly after starting Gabapentin I went to see my GP because I had gone quite deaf. She looked into my ears and told me I had bad infections in each of them. She couldn't understand why I wasn't in a lot of pain. Until she looked at my file and saw I was on Gabapentin..

[benzo]

I was doing a search on Lyrica and came across this old post, so I decided to drop this gentleman an e-mail to see how he's doing these days and if it's still working for him.
This is what he replied:

"I am very pleased to say that it still works fine with some minor lapses when I have any kind of infection – whether it is flu, a stomach upset or a flare of prostatitis (frequent burning peeing – pain can pop up for a few minutes here and there) – when infection recedes, everything is fine and I get back to jogging, swimming, cycling..

I hope this works for you"

Seems he effectively gained long-term relief from it.

I tried Neurontin a long time ago, on advice of the doctors at the pain clinic.
I quit taking it after 3 weeks because it made me feel lethargic and fatigued. It did very little in terms of pain relief so I'm not sure if Lyrica would be any different.
I understand it's a newer, better version of Neurontin.

[graeme]

i think this all depends on your main pain type and cause I beleive we suffer from both some of us have more nerve damage and others more tissue damage.

For those with neuropathic nerve pain then Lyrica would be better, but for others who have a tender tissue inflamed pain noncepetive pain then Ultram/ codeine (opioids) work well on this.

surprised Coproxamol worked if your main issue is nerve pain though.

For me Codeine ( reduces my pain 50% at the right dose 2 x 30 mg tablets when needed) and for others ultram has been a life saver.

Even though opioids have there problems there benefits in pain relief for chronic sufferer far out way them.

If I stop getting relief on my opioid then I know I could have nerve pain and Lyrica I would try

[benzo]

I think this all depends on your main pain type and cause I beleive we suffer from both some of us have more nerve damage and others more tissue damage.

For those with neuropathic nerve pain then Lyrica would be better, but for others who have a tender tissue inflamed pain noncepetive pain then Ultram/ codeine (opioids) work well on this.

surprised Coproxamol worked if your main issue is nerve pain though.

For me Codeine ( reduces my pain 50% at the right dose 2 x 30 mg tablets when needed) and for others ultram has been a life saver.

Even though opioids have there problems there benefits in pain relief for chronic sufferer far out way them.

If I stop getting relief on my opioid then I know I could have nerve pain and Lyrica I would try

Definitely.

The thing is that Elavil is supposed to work for neuropathic pain as well and that didn't do anything either. So if I tried both Elavil and Neurontin, I'm not sure what to expect from Lyrica.
I'd prefer to remain med-free actually. It's quite difficult to remain lucid when taking these meds. I hate that doped up feeling during the day. And I remember that as the worst side effect from Neurontin.

[Richard.N]

Neither Tramadol (Ultram) or Lyrica worked for me, disappointingly.

My first few doses of Lyrica made me feel like I could take on the world, but it soon faded. Tramadol just made me really anxious. It's all a bit trial and error.