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Lyrica / Pregabalin

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1 Lyrica / Pregabalin on Wed Sep 30, 2009 12:12 pm

TJW

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Lyrica (LEER-ih-kah) is the brand name used in the United States and some other countries for the seizure medicine pregabalin (pree-GABA-lin).

Lyrica is similar in structure to one of the major chemical neurotransmitters in the human brain, GABA (gamma aminobutyric acid). GABA is the most important inhibitory neurotransmitter—that is, it prevents nerve cells in the brain from firing too quickly, as they do in seizures. As it turns out, however, Lyrica does not act like GABA in the brain.

Lyrica is effective as add-on treatment for partial and secondarily generalized seizures—that is, seizures that begin in a limited area of the brain. It does not prevent primary generalized seizures such as absence, myoclonic, or primary generalized tonic-clonic seizures, which involve both sides of the brain at the same time.

It does not interact with any other seizure medicines, so it is easy to use along with other seizure medicines (so-called adjunctive therapy) to treat partial epilepsy. Lyrica may also be effective for some people when used alone (called monotherapy), although the FDA has not approved it to be used in this way.

It is not fully known how Lyrica affects the brain to stop seizures. The current theory is that Lyrica attaches to certain brain cells, at a docking station called the alpha2-delta site, and that this works in some way to block seizures.

When Lyrica and an inactive placebo were both used as add-on therapy in carefully performed studies, Lyrica reduced seizure frequency by at least half in about 30% (150 mg/day) to 50% (600 mg/day) of patients with partial onset seizures. Side effects were somewhat more troublesome than with the placebo, especially at high doses, and often went away without stopping the Lyrica.

No single combination of seizure medicines is perfect for everyone. Sometimes, a series of combinations must be tried before finding what is best for the individual. Because Lyrica generally does not interact with other medications, no adjustments are needed when it is used in combination with other seizure medicines. This feature also makes it a good choice for people (such as many elderly people with epilepsy) who need to take medicine for other disorders.

Patients with partial seizures who took Lyrica in the clinical studies and discontinued because of side effects most often mentioned:

•dizziness
•imbalance
•tiredness, sleepiness
Less common reasons for discontinuing Lyrica in the clinical studies were:

•weakness
•double or blurred vision
•trouble concentrating/thinking
•nausea
•tremor
•headache
•confusion
Other side effects that can occur when Lyrica is taken in combination with other seizure medicines include:

•accidental injury
•pain
•increased appetite
•dry mouth
•constipation
•weight gain
•swelling in the extremities (edema)
•trouble with memory
•trouble with speech
•twitching
•euphoria (feeling “high”)
If you notice problems like any of these while you are taking Lyrica, it's probably a good idea to discuss them with your doctor or nurse. Don't stop taking Lyrica or any other seizure medicine without the doctor's advice. Sometimes the doctor can help with these side effects by changing the prescription:

•reducing the overall amount
•prescribing smaller doses, to be taken more often
•changing the amount taken at certain times, such as taking a greater proportion at bedtime to reduce daytime sleepiness
Allergic reactions

There do not appear to be any allergic reactions to Lyrica.

Long-term side effects

The long-term side effects of Lyrica are not known.

Pregnancy Category C. This indicates that caution is advised, but the benefits of the medication may outweigh the potential risks. There have been no good scientific studies in women, but studies in animals have shown some harm to the fetus.

In general, the risk of birth defects is higher for women who take combinations of seizure medicines during their pregnancy and for women with a family history of birth defects. Whether this applies to Lyrica is not yet known.

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