End Fatigue

Lyrica for Fibromyalgia Pain

We have been using this for Fibromyalgia pain and have found it to be VERY helpful. Though Ultram and Skelaxin have been our first line medications for Fibromyalgia pain, Lyrica may soon move to the top of the list—especially for those with prescription insurance. It is the first medication approved by the FDA for Fibromyalgia (June 2007). Lyrica works by increasing the effect of GABA (Gamma amino butyric acid), a "calming" neurotransmitter (brain chemical). It is often very effective for fibromyalgia pain, and may also help allodynia, pelvic pain syndromes and nerve pain, as well as sleep and restless leg syndrome. It is not addictive but, like any medication, should be tapered off slowly if they've been taken for more than 2-4 months. Lyrica was the first medication to be specifically approved by the FDA for treating fibromyalgia.

Its main side effects are sedation, dizziness, and swelling. If these occur, we some times give the entire dose at bedtime (up to 200-250 mg) as it also helps sleep and start at 50 mg/day, moving the dose up slowly as tolerated. 100 mg 2 -3x day is an optimal dose, though lower doses are often effective (but again, we start with a low dose and increase as tolerated) and some people need as much as 600 mg/day. A small percent of patients (~2-4 %) will gain weight with doses of 150-300 mg/day, but this increases with higher doses. It is important to remember that, for most pain medications, the biggest cause of side effects is raising the dose too quickly. If side effects are problematic, we lower the dose and increase gradually as tolerated (I know I am repeating myself, but it is that important;-).

Lyrica Significantly Reduced Pain and Helped Patients Manage the Symptoms of Fibromyalgia, Data Show

Lyrica is First Treatment Under FDA Review for Fibromyalgia, Which Affects More than Six Million Americans

BOSTON—(BUSINESS WIRE)—Significantly more patients treated with Pfizer's Lyrica reduced their pain by 50 percent or more compared with placebo, according to study results presented today at the American Academy of Neurology annual meeting. Clinically, this outcome would equate to a patient with severe pain reporting a reduction to mild to moderate pain.

Fibromyalgia is one of the most common chronic, widespread pain conditions and is thought to result from neurological changes in how patients perceive pain. Fibromyalgia is usually accompanied by poor sleep, stiffness and fatigue. The pain of fibromyalgia can hamper a patient's ability to work and often results in increased medical costs and disability. There are no medications approved to treat fibromyalgia.

"A growing body of evidence is defining the biology behind fibromyalgia that causes such devastating and constant pain," said Dr. I. Jon Russell, one of the study's authors and associate professor of medicine in the division of clinical immunology and rheumatology and director of the university clinical research center at the University of Texas Health Science Center, San Antonio. "A reduction in pain is critical for people living with this condition. With positive new data and new treatments on the horizon, the outlook for people with fibromyalgia has never been better."

The 14-week placebo-controlled study included 745 patients with fibromyalgia who were randomized to receive Lyrica (300 mg, 450 mg or 600 mg) or placebo daily. Patients were asked to measure their pain on a scale of zero to 10; the baseline score for study participants was 6.7 on this 10-point scale.

The study found that patients receiving 600 mg a day of Lyrica reduced their pain by 2.05 on the pain scale; 2.03 for patients taking 450 mg a day; 1.75 for patients taking 300 mg a day, and 1.04 for patients taking placebo.

Significantly more patients treated with Lyrica reduced their pain by 50 percent or more compared with placebo. Of those patients taking 600 mg of Lyrica a day, 30 percent said their pain was cut in half or better; 27 percent of those taking 450 mg a day and 24 percent of those taking 300 mg also reported this level of pain relief. Of those taking placebo, 15 percent reported pain reduction of 50 percent or greater.

Patients receiving Lyrica also reported significant improvements in overall health status and outcomes, including measures such as physical function and ability to perform everyday tasks.

The most common side effects in the study were dizziness and somnolence, followed by weight gain, headache and peripheral edema.

The results of these data were submitted to the FDA as part of a supplemental New Drug Application for Lyrica for the treatment of fibromyalgia. Pfizer also intends to pursue a fibromyalgia indication in other major markets worldwide.