Help me start Lyrica

[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?

---------- 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.

[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