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ADDITIONAL INFORMATION
9 Minutes
CONTENTS
Lyrica, or the generic version, pregabalin, has become a more commonly prescribed medication for treating numerous disorders of the nervous system. This medication was originally developed by Pfizer and approved by the FDA in 2004; this is a crucial treatment for many medical conditions [1].
From 2012 to 2016, prescriptions for pregabalin increased from 39 million to 64 million in the USA (corresponding to an increase in annual prescription costs from approximately $2 billion to $4.4 billion over the same period) [2].
Approved by the FDA in 2004, this medication serves as a crucial treatment option for several medical conditions [1]. In the USA, prescriptions for pregabalin rose from 39 million in 2012 to 64 million in 2016 (annual prescription costs increased from approximately $2 billion to $4.4 billion over the same period) [2].
Lyrica is intended for use in more than one indication. It’s prescribed by healthcare providers to control the neuropathic pain that is characterized by burning, tingling, or shooting sensation a type of pain that is often associated with diabetic nerve damage or post-shingles pain. This medicine has also been found useful in treating fibromyalgia, a disorder marked by generalized pain and fatigue of the musculoskeletal system. Also, Lyrica is usually prescribed by doctors as an adjunctive therapy for adults with partial-onset seizures.
The more you know about how Lyrica works in the body, the better you’ll understand how it delivers its benefits and its risks. The medication works by attaching itself to different parts of the nervous system, including to calcium channels in nerve endings. The action of this binding decreases the release of several neurotransmitters that play a role in pain signaling, anxiety, and seizures.
The initial weeks of Lyrica treatment often bring about various physical reactions that patients should anticipate. During the first two weeks, many individuals experience dizziness, which affects approximately 46% of patients according to clinical trials published in the Cochrane Database System [3]. This dizziness typically peaks within the first few days and gradually subsides as the body adjusts to the medication.
Other common physical reactions include dry mouth, increased appetite, and mild swelling in the hands and feet. Weight gain represents another notable side effect, with studies showing that about 15% of patients gain more than 7% of their body weight within the first two months of treatment. The same meta-analysis in the Current Medical Research And Opinion reports that this weight gain often stabilizes after 3-4 months of consistent use. [4]
Mental and cognitive changes also frequently occur during the initial treatment period. Many patients report feeling unusually sleepy or experiencing difficulty concentrating. These cognitive effects typically manifest most strongly in the morning hours or after dosing. To manage these changes, healthcare providers often recommend taking the medication at consistent times and starting with lower doses that gradually increase over time.
Patients experience temporary memory issues [3] or what some describe as “brain fog.” These cognitive effects usually improve within the first few weeks as the body develops tolerance to the medication. Medical professionals recommend maintaining open communication with healthcare providers during this adjustment period, as dosage modifications might help minimize these initial side effects while maintaining the therapeutic benefits.
Lyrica is prescribed to treat anxiety, nerve pain, and epilepsy. But men and women do have biological and hormonal differences that can mean different side effects.
Especially in women taking Lyrica, the side effects are related to hormonal and metabolic systems. Women commonly report gaining weight, and some struggle to lose the extra pounds. This can become worse with hormonal changes and possibly affect menstrual cycles. Women also complain of increased fatigue and dizziness because their bodies metabolize the drug differently from men.
Subjective information from female patients has emphasized the increased occurrence of mood swings and increased emotional sensitivity compared to men [5]. Lyrica works by calming overactive nerve signals and these effects may be because it influences neurotransmitters. Women who have migraines or headaches may see an increase in frequency or intensity of migraines or headaches during the first few months of treatment, but this usually settles over time.
Lyrica can have side effects that are not so hormonally driven, but still disruptive in men. In male patients, muscle weakness and tremors appear more often perhaps as a result of Lyrica’s effect on the transmission of nerve signals. There is also a concern among men for the development of peripheral edema (swelling), which can be in the legs and feet and limit regular activities [3].
Male patients also more commonly report sexual side effects, such as reduced libido, or mild erectile dysfunction. These problems may be associated with the way in which Pregabalin affects the central nervous system, changing nerve activity and blood circulation. Although these side effects can be distressing, they may go away as your body adjusts to the medication or decrease as your dose is changed.
Knowing how long the side effects of Lyrica last can help patients work out what to expect and whether to continue with the treatment. Side effects can be temporary and go away as your body adjusts to the drug; however, some side effects may continue and need medical attention.
Side effects during the first few weeks of starting Lyrica are usually mild. Dizziness, drowsiness, and mild confusion are these temporary reactions. These effects usually show up within the first few days of treatment, as the body adjusts to the medication’s effect on the nervous system. These symptoms usually go away within one to two weeks, particularly if the dosage is increased gradually, as recommended for many.
Early on you may have gastrointestinal issues like bloating or mild nausea. Most often, these side effects go away on their own without the need for additional intervention. Fatigue, at first overwhelming, may decrease as the body becomes accustomed to the sedative effects of Pregabalin.
Although most Lyrica reactions are short-lived, some side effects can become long-term problems. For instance, weight gain is a problem in patients who are on Lyrica for a long time. It is often the result of changes in metabolism or increased appetite, which may not correct without lifestyle changes or changes in medication.
Some patients may have neurological symptoms like tremors or blurred vision that will last and need medical evaluation. In rare cases, these effects may be a sign that the patient’s nervous system is not responding properly to this medication, and may need a dosage adjustment or other treatment.
Patients should also be alert for side effects such as swelling of the extremities (edema), or joint pain, that may progress over time. If these symptoms last for several weeks or interfere with daily life, it’s important to see a healthcare provider. Lyrica may have worsened underlying conditions that lead to chronic symptoms.
The long-term effects of Lyrica are important to know for patients who use it for a long time. The drug works for chronic conditions, but extended use can cause changes in the body that need to be watched.
Long-term side effects of Lyrica can linger even after you stop taking the medication. Weight gain and persistent fatigue are among the possible metabolic changes. In a few cases, nerve-related symptoms like tingling or numbness may continue but this is less common and is more likely to be related to the underlying condition rather than the drug itself [6].
It is also possible to develop a Lyrica dependency, although much less so in patients who are taking lower doses or using it alongside other medications with addictive properties. This can show up as a difficulty to stop taking the medication or withdrawal symptoms, such as anxiety, nausea, or insomnia when you try to taper off.
They should also know about the possible cognitive effects of long-term use. While not by any means universal, some people experience lapses in memory, trouble concentrating, mental fog, or other problems. These cognitive changes may improve after the drug is stopped, but recovery time varies.
Over time, Lyrica can subtly affect how a person’s kidneys and liver work because they are the organs that process and remove the drug from the body. People on Lyrica should have regular testing if they have any preexisting conditions affecting these organs.
Long-term use can also bring swelling or fluid retention (edema) which puts more pressure on the heart and circulatory system [3]. If you have persistent edema, then you should see your doctor to have the problem addressed.
It is very important to have regular follow-ups with any healthcare provider who is managing you and have routine blood tests and assessments (as recommended) to help catch any potential long-term effects of treatment. These proactive measures help ensure benefits of taking Lyrica outweigh any risks should patients with chronic conditions work with them.
Age-related body changes concerning how the body processes medications, make elderly patients taking Lyrica, require special attention. Pregabalin may cause more side effects in older adults and may require a lower dose to be safe.
The metabolism and kidney function naturally slows as people age. Because Lyrica mostly excretes from the kidneys, when the kidneys function less efficiently, there are more drugs left in the body longer. The side effect risk is further increased by this, especially in elderly patients who are at an increased risk for falls and injuries.
Older adults may experience cognitive effects, such as memory problems or difficulty focusing, more strongly than adults under 55 years of age [5]. Drug-induced symptoms mimic or aggravate age-related cognitive decline, so it is important to differentiate between drug effects and underlying health conditions.
Fluid retention and swelling are also more common in elderly patients. The side effects can make existing conditions, such as heart failure or high blood pressure, worse and may need additional medical management.
Usually, doctors prescribe elderly patients lower starting doses of Lyrica and gradually increase dosage as tolerated and respect their kidney function in order to minimize risks. Assessments of kidney function should be done regularly to make sure the medicine is being cleared by your body well and not becoming too high.
Also, monitoring is needed to be aware of possible interactions among Lyrica with other medications that may be taken by older adults, including ones for blood pressure and anticoagulants. Side effects of these interactions can make side effects worse or reduce the efficacy of treatments for other conditions.
Elderly patients’ responses to Lyrica can be observed by caregivers or family members too. Recognizing changes to mobility, mood, or cognition early can help healthcare providers adjust the treatment plan on a timely basis, in order for it to be safe, and effective.
1. Drugs.com. Lyrica FDA Approval History. https://www.drugs.com/history/lyrica.html
2. Onakpoya IJ, Thomas ET, Lee JJ, Goldacre B, Heneghan CJ. Benefits and harms of pregabalin in the management of neuropathic pain: a rapid review and meta-analysis of randomized clinical trials. BMJ Open. 2019 Jan 21;9(1):e023600. doi: 10.1136/bmjopen-2018-023600. PMID: 30670513; PMCID: PMC6347863. https://pmc.ncbi.nlm.nih.gov/articles/PMC6347863/#R3
3. Moore RA, Straube S, Wiffen PJ, Derry S, McQuay HJ. Pregabalin for acute and chronic pain in adults. Cochrane Database Syst Rev. 2009 Jul 8;(3): CD007076. Doi: 10.1002/14651858.CD007076.pub2. Update in: Cochrane Database Syst Rev. 2019 Jan 23;1:CD007076. Doi: 10.1002/14651858.CD007076.pub3. PMID: 19588419; PMCID: PMC4167351. https://pubmed.ncbi.nlm.nih.gov/19588419/
4. Cabrera J, Emir B, Dills D, Murphy TK, Whalen E, Clair A. Characterizing and understanding body weight patterns in patients treated with pregabalin. Curr Med Res Opin. 2012 Jun;28(6):1027-37. doi: 10.1185/03007995.2012.684044. Epub 2012 May 3. PMID: 22494020. https://pubmed.ncbi.nlm.nih.gov/22494020/
5. Gajraj, Noor M. MD, FRCA, DABPM. Pregabalin: Its Pharmacology and Use in Pain Management. Anesthesia & Analgesia 105(6):p 1805-1815, December 2007. | DOI: 10.1213/01.ane.0000287643.13410.5e
6. Cleveland Clinic. Pregabalin Capsules. https://my.clevelandclinic.org/health/drugs/19097-pregabalin-capsules
The way Lyrica affects sleep can be different. Some people say that it helps them sleep better since it reduces pain or anxiety, while others may feel unusually drowsy or really tired throughout the day. On the other hand, some patients record insomnia or disruption of sleep cycles, as a result of the impact of the drug on the nervous system. These issues might be adjusted by changes in timing or dosage.
Most side effects are temporary and go away when you stop the drug, but some chronic users might experience ongoing problems such as cognitive changes, weight gain, or nerve problems. Such cases are rare. Side effects could be permanent in people with preexisting conditions, using Lyrica for a long period or in large doses. Risks can be mitigated by regular monitoring and keeping in touch with a healthcare provider.
Headaches are possible side effects of Lyrica. These are often mild and temporary, kind of what would be expected in the early stages of treatment as your body learns the medication. The physician should be contacted if the headaches do not go away or get worse, which may be a sign that the dosage needs adjustment or that another approach should be used.
Lyrica may cause erectile dysfunction (ED), a possible side effect said to be caused by Lyrica’s effect on blood flow and nerve signaling. This effect usually is temporary and goes away once the medication is stopped. ED usually goes away on its own, but if it doesn’t, an underlying condition or other factor may be behind it, and medical evaluation may be advisable.
Some patients taking pregabalin (Lyrica) may experience urinary side effects: difficulty urinating, increased frequency of urination, or, rarely, urinary retention. These effects can be uncomfortable and may suggest nerve-related effects of the medication. If urinary changes are significant, patients should see a doctor to see if there are complications or if treatment needs to be changed.
Lyrica doesn’t have special diet restrictions, but some patients reported increased appetite or cravings for carbohydrate-rich foods while on the medication related to weight gain. Balance diet and precautions for calorie intake, not to reduce weight in any case. You should also drink alcohol in moderation because it can increase side effects such as dizziness or drowsiness.
Blood pressure can be affected by Lyrica and on occasion, there may be heart palpitations. Some patients will see a drop in blood pressure leading to lightheadedness, while others will experience an irregular or racing heartbeat. While these side effects are rare, they should be reported to a doctor if they happen, particularly in people with preexisting cardiovascular conditions.
Some people are taking Lyrica and have become more sensitive to hot or cold. This may show up as chills sweating, or the inability to stay inside in the heat for more than a couple minutes. How these responses work, scientists believe, is by the medication affecting nerve signals and a body’s regulatory systems. To alleviate discomfort patients should dress appropriately for the weather and stay hydrated.
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