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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by ben on June 25, 2005, at 9:07:02
Hello
Anyon switched from Neurontin to Lyrica ? What are the pros and cons ? I read that Lyrica acts very similar to benzodiazepines because it as an immediate effect on anxiety! I have Neurontin as mood stabilizer and against pain but Lyrica sounds promissing against fibro pain, anxiety and as mood stabilizer. I should go off Neurontin because it is very constipating - treatment restistant!
Posted by mworkman on June 25, 2005, at 10:42:58
In reply to From Neurontin to Lyrica ?!, posted by ben on June 25, 2005, at 9:07:02
I think they are basicly the same, lyrica was just made because neurontin was/is going off patent.
Posted by Jakeman on June 25, 2005, at 16:16:42
In reply to Re: From Neurontin to Lyrica ?!, posted by mworkman on June 25, 2005, at 10:42:58
> I think they are basicly the same, lyrica was just made because neurontin was/is going off patent.
Is Lyrica now availble in the US?
thanks ~Jake
Posted by rod on June 25, 2005, at 20:55:15
In reply to From Neurontin to Lyrica ?!, posted by ben on June 25, 2005, at 9:07:02
Hi,
I have taken Neurontin before I switched to Lyrica. Big difference is weigt gain. Neurontin was weight neutral to me, but I gained 10 kg since adding Lyrica. Lyrica is less sedating as Neurontin.
And as far as I know, in general, Neurontin is not an effective mood stabliliser, and actually made cycling worse for some..The main effect of Lyrica to me is its making me more resistant to stress... And makes me think more clearly. whyever
good bye
Roland
Posted by ben on June 26, 2005, at 0:03:50
In reply to Re: From Neurontin to Lyrica ?!, posted by mworkman on June 25, 2005, at 10:42:58
> I think they are basicly the same, lyrica was just made because neurontin was/is going off patent.
It is a total different molecule, so I dont think that is only about the patent.
Posted by ben on June 26, 2005, at 1:12:13
In reply to Re: From Neurontin to Lyrica ?!, posted by ben on June 26, 2005, at 0:03:50
Gabapentin has a saturable bioavailabilty - that means if you are taking about 1600 mg/day it is nearly the same as 2400 or 3600 mg/day. I remember someone said "the problem with Neurontin is it stops working after some time". Thats perhaps the reason. Your system adapts in a way and then you cant give your system more of gabapentin. The uptake is limited = saturable. What about pregabalin? Why it is causing weight gain? It doesnt act exactly like gabapentin or not only like gabapentin. Is there any influence on the HP axis?!
Posted by ben on June 26, 2005, at 8:40:00
In reply to Neurontin has saturable bioavailability!, posted by ben on June 26, 2005, at 1:12:13
Epilepsia. 2004;45 Suppl 6:13-8.
Pregabalin pharmacology and its relevance to clinical practice.
Ben-Menachem E.
Department of Clinical Neuroscience, Sahlgrenska Academy, Goteborg University, Goteborg, Sweden. Elinor.Ben-Menachem@neuro.gu.se
Pregabalin is a potent ligand for the alpha-2-delta subunit of voltage-gated calcium channels in the central nervous system that exhibits potent anticonvulsant, analgesic, and anxiolytic activity in a range of animal models. In addition, pregabalin has been shown to be a highly effective adjunctive therapy for partial seizures in clinical trials. Potent binding to the alpha-2-delta site reduces depolarization-induced calcium influx with a consequential modulation in excitatory neurotransmitter release. Pregabalin has no demonstrated effects on GABAergic mechanisms. Pregabalin demonstrates highly predictable and linear pharmacokinetics, a profile that makes it easy to use in clinical practice. Absorption is extensive, rapid, and proportional to dose. Time to maximal plasma concentration is approximately 1 h and steady state is achieved within 24-48 h. These characteristics reflect the observed onset of efficacy as early as day two in clinical trials. High bioavailability, a mean elimination half life (t(1/2)) of 6.3 h, and dose-proportional maximal plasma concentrations and total exposures predict a dose-response relationship in clinical practice and allow an effective starting dose of 150 mg/day in clinical practice without need for titration. Administration with food has no clinically relevant effect on the amount of pregabalin absorbed, providing for a dosing regimen uncomplicated by meals. Pregabalin does not bind to plasma proteins and is excreted virtually unchanged (<2% metabolism) by the kidneys. It is not subject to hepatic metabolism and does not induce or inhibit liver enzymes such as the cytochrome P450 system. Therefore, pregabalin is unlikely to cause, or be subject to, pharmacokinetic drug-drug interactions--an expectation that has been confirmed in clinical pharmacokinetic studies. However, dose adjustment may be necessary in patients with renal insufficiency. Thus, the pharmacological and pharmacokinetic profiles of pregabalin provide a predictable basis for its use in clinical practice.
Publication Types:
Review
Review, TutorialPMID: 15315511 [PubMed - indexed for MEDLINE]
Posted by ed_uk on June 26, 2005, at 8:45:40
In reply to Lyrica acts not via GABA!, posted by ben on June 26, 2005, at 8:40:00
Hi Ben :-)
>Lyrica acts not via GABA!
Neither does Neurontin, it was a myth that it did! Neurontin and Lyrica appear to have the same mechanism of action.
~Ed
Posted by ben on June 26, 2005, at 13:34:14
In reply to Re: Lyrica acts not via GABA! » ben, posted by ed_uk on June 26, 2005, at 8:45:40
> Hi Ben :-)
>
> >Lyrica acts not via GABA!
>
> Neither does Neurontin, it was a myth that it did! Neurontin and Lyrica appear to have the same mechanism of action.
>
> ~Edhi ed :-)
is the pregabalin really stimulating! i cant believe that after my own experience with gabapentin. what do you thin about pooping off because of saturable uptake -> you cant force the system for a reaction again because you cant get more substance via absorption. there are people who are sying gabapentin isnt a mood stabilizer. what do you think and of course of pregabalin too.
ben
Posted by Tom Twilight on June 26, 2005, at 14:43:34
In reply to Re: Lyrica acts not via GABA! » ed_uk, posted by ben on June 26, 2005, at 13:34:14
This is really interesting, but I don't really understand it
How does Lyrica work? What other calming Neurotransmiters are there, Other than GABA?
Posted by ed_uk on June 26, 2005, at 18:44:11
In reply to Re: Lyrica acts not via GABA! » ed_uk, posted by ben on June 26, 2005, at 13:34:14
Hi Ben :-)
>is the pregabalin really stimulating!
I'd expect it to be quite similar to gabapentin. How do you find gabapentin?
>what do you thin about pooping off because of saturable uptake
I wouldn't expect the absorption to change over time. Pregabalin sometimes seems to poop out too!
>there are people who are sying gabapentin isnt a mood stabilizer......
I think it's somewhat effective for anxiety but it doesn't seem to be particularly effective for mania.
Kind regards
~Ed
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