Help me start Lyrica

[misfits73]

Went to my doc last week,
i told him Lexapro does not do a thing with the physical symptoms of my anxiety, my sex drive is gone and why am i described SSRIs since i dont feel depressed?Only Xanax helps with tremors etc which i'm still taking before going out (0.25mg per day)

After an argument with him, he admitted SSRIs not working for me(Zoloft,Seroxat,Lexapro) neither SNRIs will, and he threw on the table Lyrica!In fact he was between Cymbalta and Lyrica but decided Lyrica.
You can start with 50mg every night for 10 days and we'll see how it goes.
He insisted it will help me.

I have the tablets next to me but i'm afraid taking them after reading the horror stories about Lyrica (tolerance, withdrawal etc)

Should i give Lyrica a try?Opinions please

I'm weaning off Lexapro at the moment, all good so far.

[hanshan]

Hi Misfits,

Pregabalin has a pretty good profile re tolerance and withdrawal. If it works, most people seem to find a level that they maintain quite happily over an extended period. There are horror stories for every med posted on the internet - they don't mean much.

Should you try it? It's worth a try - pregabalin works best for generalised anxiety, but may be helpful for other anxiety.

[SmilingAlbert]

+1

As Hanshan says, if you look hard enough you will find horror stories about absolutely everything, including placebos. People shout about these, while the majority of people who meds work for just get on with their lives and say nothing about it.

Some of the horror stories around SSRIs, especially at start-up, have truth (I have been there), but my start-up experience of Preg was frankly wonderful; months of stupid, irrational wound-up tension and worry went in 24 hours.

I have been on it for 18 months now, on the same dose, and it gave me my life back. I would give it a try, as it seems to work for many more people than it does not.

Good luck!

Albert

[misfits73]

Thanks for your replies guys,

i'm suffering from social phobia/anxiety which gives me teribble tremors in my legs/arms leading to panic attacks, thus i cant leave house without Xanax first.
Once i take Xanax all is fine (0.25mg)

SSRIs did nothing, so we discussed on alternatives and he suggested Lyrica.

what dose are you on SmilingAlbert?

[hanshan]

I have had some social phobia problems, for which pregabalin has been helpful. 50 mg is a very low dose - therapeutic range is currently put at 200 - 600 mg per day, but different people respond quite differently.

[misfits73]

While on Lyrica, do you get that calm effect you take from benzos?

Did you gain any weight, become more hungry?
Any sexual disfunction?

As i like go out, alcohol is a major factor for me;I can have two beers 3 hours after taking Xanax without feeling dizzy/drunk at all.
Does this 3 hour gap apply for Lyrica as well?

[SmilingAlbert]

hi misfits,

I am on 225mg - 150 at night, 75 in the AM

Can make you hungry, so be prepared to discipline yourself, esp. at first

no sexual problems

Booze not allowed in theory - reality is many people do in moderation, including me, with no problems. Booze may amplify effects though so aim to drink less than usual, and don't drive.

[hanshan]

I agree with Albert's comments above, but I'd be worried if you wanted to combine a benzodiazepine, pregabalin and alcohol. It's not a sensible option.

[SmilingAlbert]

+1

Apologies - missed the Xanax angle -

Yes mixing Preg, Xanax and booze is potentially very dangerous; many people seem to use Preg to wean themselves off benzos like Xanax, and it seems to be quite successful.

It is also medically more orthodox: many doctors wont prescribe benzos for long periods because of dependence etc., but have no problems with long-term prescriptions for Pregabalin.

There seems to be a lot online about the benzo->Preg journey, though of course be cautious as to what you believe as there are a lot of abusers of both medicines out there.

Albert

[misfits73]

Thanks guys, i'll keep you updated

[shiznit76]

how are you getting on with this? Where in UK are you?

[misfits73]

Started on 50mg before bed for 10 days, no difference at all.
Today it's my 5th day on 75mg, feeling the calm effect and sleeping a little bit better.
The only side effects i'm having on 75mg is some fatigue and i want to sleep more.
So at the moment i'm on 0.25mg Xanax in the morning and 75mg Lyrica at night, we'll see when i reach 150mg per day.

I'm in the Bucks area, cheers for asking

[shiznit76]

Started on 50mg before bed for 10 days, no difference at all.
Today it's my 5th day on 75mg, feeling the calm effect and sleeping a little bit better.
The only side effects i'm having on 75mg is some fatigue and i want to sleep more.
So at the moment i'm on 0.25mg Xanax in the morning and 75mg Lyrica at night, we'll see when i reach 150mg per day.

I'm in the Bucks area, cheers for asking

Did the Dr prescribe them with no issues? Heard these can be hard to get prescribed

[MyNameIsTerry]

Started on 50mg before bed for 10 days, no difference at all.
Today it's my 5th day on 75mg, feeling the calm effect and sleeping a little bit better.
The only side effects i'm having on 75mg is some fatigue and i want to sleep more.
So at the moment i'm on 0.25mg Xanax in the morning and 75mg Lyrica at night, we'll see when i reach 150mg per day.

I'm in the Bucks area, cheers for asking

Wow, you were lucky! Preg is blacklisted in Bucks. They won't even prescribe it for epilepsy. So, your doctor has "off labelled" it with the local formulary but prescribed "as licenced" per the national formulary.

I wonder how they are getting on with that? I remember seeing the local trust having a process in to use backlisted meds but they needed approval first. So, was it a specialist that prescribed them as they have greater powers?

[misfits73]

I said i live in Bucks, that doesnt necessary mean i prescribed the drugs in Bucks :).

[hanshan]

Hi Misfits,

No worries. It's an established part of medical practice that doctors can (in theory, with some limitations) prescribe any medication for any condition.

The whole "licensed medication" and "off-label prescription" nomenclature is a way of controlling prescriptions for financial reasons as well as therapeutic.

In any case, off-label prescription is perfectly legal when it doesn't involve highly controlled drugs, such as narcotics.

[shiznit76]

Hi Misfits,

No worries. It's an established part of medical practice that doctors can (in theory, with some limitations) prescribe any medication for any condition.

The whole "licensed medication" and "off-label prescription" nomenclature is a way of controlling prescriptions for financial reasons as well as therapeutic.

In any case, off-label prescription is perfectly legal when it doesn't involve highly controlled drugs, such as narcotics.


Are there not moves to make pregabalin a more controlled drug?

[hanshan]

None that I know of. It has undergone all the necessary trials.

[MyNameIsTerry]

There have been some press stories about Pregabalin and addiction but they are just biased. One hanshan will remember from last year in the UK (see SmilingAlbert's "Pregabalin In The News" thread) was aimed at highlighted the addictive nature of the drug yet it was a story from one worker and it was all based on existing substance misusers. It was just spin. Adding any drug to a cocktail of illegal Benzo's, heroine and all sorts isn't medical treatment. Those people would just get it off drug dealers anyway (it's a misused substance in our prison's) and there shouldn't even be an issue if GP's are doing what they should be to prescribe them properly.

Whilst this drug may not be used as much for it's GAD licence, it will be licenced more extensively for it's epilepsy one so trying to can it would be problematic. They would have to prove it's addictiveness and yet there is no proof worldwide of this. Basically, it's a very expensive drug when a bean counter in the NHS looks at Citalopram or Sertraline and seems a 2 prescriptions of Preg costs as much as 12 months of those. So, do you think it's about the drug or about saving money? :winks:

---------- Post added at 08:35 ---------- Previous post was at 08:32 ----------


Hi Misfits,

No worries. It's an established part of medical practice that doctors can (in theory, with some limitations) prescribe any medication for any condition.

The whole "licensed medication" and "off-label prescription" nomenclature is a way of controlling prescriptions for financial reasons as well as therapeutic.

In any case, off-label prescription is perfectly legal when it doesn't involve highly controlled drugs, such as narcotics.

Very true, hanshan. The only problem we have with the Bucks region is the local trust has put it on a backlist to prevent it's prescription. It's only about cash though, it's not just GAD they banned it for it was epilepsy too and if you dig into it you can find references to switching patients to Gabapentin based on cost analysis exercises.

I find it so strange that GP's are very cautious about "off labelling" yet they dish out Citalopram for anxiety without a second thought. Citalopram isn't licenced for anxiety disorders.

---------- Post added at 08:35 ---------- Previous post was at 08:35 ----------


I said i live in Bucks, that doesnt necessary mean i prescribed the drugs in Bucks :).

Nuff said. :yesyes:

[SmilingAlbert]

Well said Terry.

I hate all this 'addictive' stuff anyway - what does it even mean in the context of managing people's health?

Are the millions of people who take statins addicted? Perhaps their hearts are - but does anyone truly believe that this is bad, and they should be weaned off it, so they get heart attacks instead?

Are the millions of people who take Ventolin addicted because their lungs can't function without it? Should we just wean them off and let them die instead?

Why is it any different AT ALL if people have to take MH medicines long-term? For me, it's exactly the same thing.

We should instead beware of tolerability - i.e. a patient has to take an ever-rising dose to get the same effect. This does appear to be the case with benzos, and indeed a reason why docs don't like using them except in emergency, and I understand that - eventually you run out of ammo, as you are kicking the can down the road.

There is scant evidence of this problem with Preg; many people on this board (e.g me) have been on the same dose for years and it's still doing what it was designed to do: help people manage what can be a highly debilitating condition.

As I have said here before, these medicines were invented by brilliant scientists at vast expense for a reason: to be used, and to help millions of people live their lives better. As with statins, Ventolin and the rest, I couldn't give a stuff if people have to take them for a long time; in my case, Preg allows me to be a functioning tax-paying adult, to help pay for my family and with it, into the NHS; without it, I doubt I'd be one, frankly.

As I have also said here, I deplore the way that SSRIs are given out like smarties by under-trained GPs to under-prepared patients who are already at the end of their tethers. Oh great, that stupid legalese leaflet mentions higher rates of *bad thoughts* ideation? So you give people who already are thinking those thoughts pills that make that idea even bigger, and tell them "oh don't worry, you'll get through it in a week or 2", a period when every hour can feel like a week?

Oh, and then tell them they can see a psychiatrist in a month or 2, if they're lucky?

I have been there: right at the start of my MH journey, I went down this route and was given some SSRI: I thought I was losing my mind, instead of being given a medicine that I hoped would - frankly - have calmed me down quickly, which was what I needed. As Terry once said here: I have a sore nose, so you now want to use a hammer on my nose now? Thanks a bunch guys.

For example, Preg v Sertraline:
http://www.ncbi.nlm.nih.gov/pubmed/26125277

"In the patients treated with sertraline, the anxiolytic effect was detectable after at least 14 days while pregabalin showed initial good results during the first week of treatment."

For somebody who has never experienced MH issues, they might think "oh a week difference, what does that matter?" I would say it matters the whole world for people who are in a mess.

All the evidence is that Preg works quickly and effectively for *most* people, helps the restless rest and sleep, and can carry on working at more or less the same dose for a long period. One day when Preg is as generic and cheap as the older SSRIs I sincerely hope it will be a first line medicine for GAD, and I truly believe will not only help many more people, but actually sharply reduce *worse outcomes*.

Sorry to go on but as regulars know I have strong views about all this, and sincerely want as many people as possible to benefit from medicine that data has proven can be very effective.

If you have to use it for a long period, so be it - just like some of the world's most prescribed drugs like Lipitor (cholesterol - heart), Ventolin (asthma), Plavix (heart), Nexium (stomach), Actos (diabetes): they save lives; use them.

Albert