Lyrica interactions

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Lyrica (Pregabalin) Interactions: A Comprehensive Overview

Introduction to Lyrica (Pregabalin)

Lyrica, known generically as pregabalin, is a medication primarily used to treat epilepsy, anxiety disorders, and neuropathic pain. It functions by modulating the release of neurotransmitters, thereby reducing the intensity of pain signals in the nervous system. However, its interactions with other substances and its impact on various physiological systems warrant careful consideration.

Efficacy in Treating Neuropathic Pain in Knee Osteoarthritis

A study comparing the effectiveness of pregabalin to paracetamol in patients with knee osteoarthritis (OA) exhibiting neuropathic pain found that pregabalin significantly reduced pain and improved physical function. Participants receiving pregabalin showed greater reductions in WOMAC Pain scores and PainDETECT scores, as well as increased pressure pain thresholds, indicating reduced tenderness . This suggests that pregabalin may be more effective than paracetamol for this specific patient cohort.

Impact on Reproductive Health

Research on the effects of pregabalin on male reproductive health in Wistar rats revealed significant adverse outcomes. Pregabalin administration led to disrupted hormone secretion, increased oxidative stress, DNA damage, and altered testicular histology. These findings indicate that pregabalin can negatively impact the hypothalamus-pituitary-gonad axis, potentially affecting fertility . This highlights the need for caution when prescribing pregabalin to populations concerned with reproductive health.

Postmortem Analysis and Toxicity

An analysis of pregabalin concentrations in postmortem human samples from 18 cases, including one mixed overdose, demonstrated that pregabalin can be a contributing factor in fatalities. The study utilized a hydrophilic interaction liquid chromatography technique coupled with high-resolution mass spectrometry to quantify pregabalin levels in various tissues. The findings showed significant variability in pregabalin concentrations across different individuals, with some cases indicating pregabalin as a likely factor in the cause of death . This underscores the importance of monitoring pregabalin levels in patients, especially those at risk of overdose.

Conclusion

Pregabalin (Lyrica) is a potent medication for managing neuropathic pain and other conditions, but it comes with significant considerations regarding its interactions and side effects. Its efficacy in reducing pain in knee osteoarthritis patients with neuropathic pain is well-documented, yet its potential adverse effects on reproductive health and the risk of toxicity in overdose cases necessitate careful monitoring and judicious use. Further research is essential to fully understand the breadth of pregabalin's interactions and to optimize its safe application in clinical practice.

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Most relevant research papers on this topic

SAT0487 A randomized, blinded, comparator-controlled trial investigating a 4-week course of lyrica in subjects with knee osteoarthritis who exhibit neuropathic pain, compared with a 4-week course of paracetamol

Pregabalin (300mg) is more effective in reducing pain and improving function than paracetamol in people with knee osteoarthritis who exhibit neuropathic pain.

RCT

2017·

3citations

·A. Wright et al.

How the Pregabalin (Lyrica) Administration as an Abuse Drug Can Affects the Reproductive Health of Male Wistar Rat

Addiction to pregabalin (Lyrica) negatively impacts male reproductive health and fertility by hindering hormone secretion, raising reactive oxygen species, and causing DNA damage and testicular histology.

RCTAnimal Study

2021·

0citations

·Nouf Bader Alduweesh

Quantification of pregabalin using hydrophilic interaction HPLC-high-resolution MS in postmortem human samples: eighteen case reports.

Pregabalin concentrations in postmortem human samples ranged from 0.4 to 17.0 g/mL, with potential as a cause of death in 3 cases, and were found in peripheral blood, central blood, urine, and bile.

Case Report

2014·

36citations

·C. Priez-Barallon et al.

A pilot, double‐blind, placebo‐controlled trial of pregabalin (Lyrica) in the treatment of essential tremor

Pregabalin (Lyrica) significantly reduced tremor amplitude and improved action tremor limb scores in essential tremor patients, but larger studies are needed for further evaluation.

RCT

2007·

52citations

·T. Zesiewicz et al.

Pregabalin reduces cocaine self‐administration and relapse to cocaine seeking in the rat

Pregabalin reduces cocaine self-administration and relapse to cocaine seeking in rats, suggesting potential for treating cocaine addiction.

Non-RCTAnimal Study

2013·

37citations

·G. Guglielmo et al.

Analgesia with Gabapentin and Pregabalin May Involve N-Methyl-d-Aspartate Receptors, Neurexins, and Thrombospondins

Gabapentin and pregabalin's analgesic effects may involve interactions with N-methyl-d-aspartate receptors, neurexin-1, and thrombospondins, in addition to voltage-gated calcium channels.

2020·

34citations

·C. Taylor et al.

LYRICA NIGHTS–RECREATIONAL PREGABALIN ABUSE IN AN URBAN EMERGENCY DEPARTMENT

Pregabalin recreational abuse can lead to seizures and ICU admissions, requiring emergency physicians to be aware of its use and potential toxicity.

Case ReportRigorous Journal

2013·

41citations

·J. Millar et al.

Listening to Lyrica: contested illnesses and pharmaceutical determinism.

Pharmaceutical determinism, influenced by Lyrica's approval, promotes and legitimizes contested illnesses, highlighting the need for patients to challenge the industry's role in illness validation.

Rigorous JournalHighly Cited

2011·

80citations

·K. Barker

A DFT investigation of structure, spectroscopic properties and tautomerism of the anticonvulsant drug Lyrica.

The most stable conformer of Lyrica is the L1 (-OH form), which can be tautomerized to the L5 (-NH form), with DFT-based calculations in agreement with experimental values.

2015·

16citations

·Zohre Sadeghzade et al.

Pharmacology and mechanism of action of pregabalin: The calcium channel α2–δ (alpha2–delta) subunit as a target for antiepileptic drug discovery

Pregabalin reduces neuronal excitability and seizures by binding to the alpha2–delta subunit of voltage-gated calcium channels, potentially through reduced neurotransmitter release.

Highly Cited

2007·

461citations

·C. Taylor et al.

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