Lyrica: The Best Companion for Mental Disorders
Pregabalin, the basic and primordial component of Lyrica, is a drug widely used worldwide as an antiepileptic and analgesic. From the beginning it has been considered an effective treatment, which does not have as many adverse effects as most of the anticonvulsants available today.
This is a specific ligand that acts similar to neurotransmitters, molecules specialized in communicating neurons between them and with the rest of the tissues where they have an action.
The Food and Drug Administration (FDA) approved the use of this drug in the USA several years ago, for the treatment of seizures (especially partial seizures in adults) and some other complications such as peripheral diabetic neuropathy, postherpetic neuralgia and fibromyalgia. Some even claim that it can also be used for spinal cord injuries.
There are many studies where it has been approved with other indications that perhaps go a little beyond what the FDA has said, so even the European Union approved it for other types of neuropathic pain, generalized anxiety and as part of treatment in epilepsy.
Although it does not have the same adverse effects as other drugs intended for similar purposes, it also has its own undesirable effects. For example, there may be dizziness, drowsiness and weight gain, as well as peripheral disorders caused by the direct action of the drug.
This is an important and key treatment for many people in the world today. Undoubtedly, it is quite safe and recommended by doctors, as well as by the international organizations in charge of supervising its use and administration, so we can be reassured with its use. Let's talk a little more about each of its characteristics and what it represents.
Mechanism of Action - How Does It Work?
Although it is quite "molecular" the way this drug works, we can try to explain it in a simple way so that it is understood. First of all, let's remember that this is a drug that after entering the body, is going to metabolize to become GABA, or rather a molecule extremely similar to it.
The role of this neurotransmitter is to inhibit or greatly decrease neuronal activity, which is responsible for several delicate functions in our brain, such as cognition, behavior, and response to stress.
Even so, although their effect is closely linked, they stimulate different points and use different receptors to perform their function. In fact, scientists (who previously believed that GABA and the metabolite of Pregabalin acted in the same place), now claim that the effects of this drug are due to the union with a sub-unit called alpha2D.
The important thing about understanding this relationship is that the actions are regulated by different routes, so the original GABA can continue to exert its effect while the pregabalin collaborates from a different action point, so that they support each other and achieve a better therapeutic action.
Indications of Pregabalin
As mentioned above, there are several different indications for pregabalin, and each will have its own dosage schedule and the proper way in which it should be taken. However, we want to emphasize something quite important before we start with the indications.
Only your doctor will be able to diagnose you and prescribe this medicine. The neurological and psychiatric pathologies treated by this drug are quite delicate, so they need a proper diagnosis and treatment, which often involves the use of more than one drug, but several. Therefore, do not use Pregabalin on your own.
Now, going back to the indications, let's talk a little bit about each of them and how the Lyrica interacts.
To talk about this disease we have to make an important first division. Epilepsy is a disease characterized by primary convulsive episodes that have no other apparent cause but are essential. In the case of seizures, it is a symptom that may be associated with many diseases that have some degree of neurological impact.
Pregabalin is special in epilepsy because it can raise something known as the "threshold" of seizures. That is, it can decrease the likelihood or ease with which these disorders can occur. However, they are not able to avoid some specific types of generalized seizures, but are better in partial seizures.
In relation to the above mentioned mechanism of action, it turns out that the origin of epilepsy (in most cases) is found in the entorhinal, piriform and insular cortex. In these sites it seems that alpha2D subunits abound, so the effect of pregabalin is excellent.
The best thing is that this mechanism of action differentiates it from other common anticonvulsants, since it not only has inhibitory actions similar to that of GABA, but also decreases some other excitatory neurotransmitters such as glutamate.
Finally, Lyrica has been found to have neuroprotective functions that may be useful in decreasing traumatic seizures. Undoubtedly, it may be a special medication to treat both epilepsy and to placate seizure symptoms.
Hyperalgesia is also a symptom that may appear in neurological disorders, especially those associated with chronic conditions with some degree of psychological involvement. However, Lyrica is also an effective drug in these cases.
The available evidence indicates that this drug may decrease exacerbated painful responses, given that this drug is closely related to the processing of nociceptive information through the same interaction with the alpha2D subunit, which is expressed much in the areas that are responsible for processing and responding to pain.
There are many scientific studies that have been conducted to confirm that pregabalin is useful in the treatment of neuropathic pain. In these, it was shown that sensitization and pain are decreased, as well as the abnormal increase in normal pain responses.
The good thing that in recent years there has been more awareness of mental illness is that more pharmaceutical industries are willing to research and produce new drugs that can help with a variety of different disorders.
Anxiety disorders involve several different subtypes of illnesses characterized by a temporary or generalized fear, which causes organic or psychological events ranging from simple avoidance behaviors to panic attacks, which are quite serious and complicated.
Pregabalin has anxiolytic effects thanks to the same activity it has on alpha2D-1. This subunit is expressed in areas that are strongly related to the process of emotional information and consciousness about our body. Even, like other of the best anxiolytics, it seems to have specific molecular sites apart from the subunit mentioned.
The drug has been shown to be at the same level as benzodiazepines for the treatment of anxiety, but with fewer side effects such as sedation, which is one of the most troubling. Similarly, it does not appear to affect cognition, making it a special drug and ideal for this type of trastonors.
How to Use Lyrica
The mode of use will depend almost directly on the presentation that you get or that your doctor orders you. It comes both in capsules, which are quickly degraded, and in oral solutions and in a slow-release (solid) tablet to be administered orally as a continuous or long-acting treatment.
The capsules and the solution have the similarity that they can be taken two or three times a day without there being a significant relationship with the food, which means that it can be taken at any time. On the other hand, slow-release tablets should be taken at the end of the day, after dinner, so that the food does not interfere with their prolonged release and has the desired effect.
In the case of both capsules and tablets, do not chew or crush or dissolve them, especially the tablets. This is because the slow-release effect will be lost and you will be at risk of an overdose of pregabalin, which has quite counterproductive effects which we will explain later.
Also, remember to take exactly as directed. Pregabalin can act like a drug, creating some kind of mild addiction, so you should not increase the dose or frequency of use unless your doctor tells you to.
Remember, beyond the fact that pregabalin is capable of effectively controlling the symptoms of the diseases mentioned above, we remind you that this is a symptomatic medicine that is not intended to cure any disease, but to make the healing process faster and simpler.
It is necessary to combine this medicine with the rest of the therapy that is necessary in order to achieve the cure. In most cases it is psychotherapy, but depending on the illness you have, you may need other drugs.
On the other hand, the effect of pregabalin is usually progressive, which means that it may take several days or weeks to reach maximum effect, although it is likely that you may see improvement in the short term. Therefore, you should not stop taking lyrica even if you do not see the effects immediately. To do this, consult your doctor if you want to do so.
If you stop taking pregabalin quickly, you may have significant withdrawal symptoms, which can affect the way you sleep or cause strong gastrointestinal symptoms. To be able to stop using this medication, your doctor will tell you to decrease the dose progressively and extend the intake interval until necessary.
Guidelines Before Taking Lyrica
It is important that, before you begin treatment with this medication, you tell your doctor if you are allergic to this or any other treatment you know of. Allergic reactions can be complicated to treat, especially when we are under the effect of that medication.
On the other hand, tell your doctor which medications you are taking beyond pregabalin, with or without a prescription, even if you are taking a nutraceutical or herbal supplement. All of these can interact with pregabalin and cause serious damage to your body. To avoid this, the way in which we take our medications should be regulated.
On the other hand, if you are a drinker or use drugs in addition to other illegal drugs, you need to tell your doctor. Adverse reactions in these cases can include serious disorders such as fulminant liver failure, which can kill you in a short time.
If you are pregnant, you should report it as soon as possible, even if you want to have children soon with your partner. Pregabalin has been shown to decrease the fertility of animals and increase the likelihood of birth defects, so it can be dangerous within pregnancy or if you are seeking to conceive. We recommend that you see your doctor and plan your pregnancy before you have a baby.
Finally, all the illnesses you have should be mentioned. For example, if you have a problem with your liver or kidneys, you can affect the way you metabolize the drug, which will increase its harmful concentrations in your body and can permanently injure you.
Even if you are cautious about using Lyrica, it can directly affect a number of diseases you may have. That's why you need to tell your doctor and take specific steps to reduce the chance of a direct injury.
What if I miss a dose?
The most important thing is to keep in mind when the next pill is due. Whether you are taking capsules, tablets or the oral solution, the most important thing is that you try to take the dose as soon as you remember that you forgot. However, if you are very close to the next dose, it is best to skip the missed dose and continue with your schedule.
Don't try to take two doses because you missed one. In general, all drugs that affect the central nervous system can be very dangerous when taken in excess, so it's best to wait, so you lose some of the effect of the medication.
If you are taking slow-release tablets the thing changes just a little bit. For example, if you forgot to take it after dinner, but it's still night, we recommend that you have a small snack and take the pill later. On the other hand, if it is morning and you forgot the night before, have breakfast and then proceed to take the pill.
Slow release tablets are more delicate than conventional tablets because the time between doses is much longer. For this reason, if you forget to take it for a long time we advise you to be alert to any possible symptom that appears so that you are able to treat it in time.
As we have been saying, drugs that act on the central nervous system are the most dangerous in terms of adverse effects. In fact, antipsychotics (used for illnesses such as schizophrenia) can cause symptoms that simply do not allow the patient to maintain a normal life.
However, the story of pregabalin is a little different. Being more specific and having a different mechanism of action, it further limits the possible adverse effects that appear after use. Still, of course, it is normal that there are some symptoms that are not desired after the use of the drug.
Among the most frequent we have:
- Gastrointestinal symptoms: not only diarrhea and vomiting, but can also cause constipation, increased gas, abdominal distension, dry mouth, etc.. Most of these drugs usually cause this type of adverse effect, including those not related to the central nervous system.
- Anxiety: paradoxically, symptoms related to anxiety may increase at the beginning of pregabalin use. This is a fairly common adverse effect, so anxious patients often start their therapies with a little benzodiazepine in conjunction with pregabalin. Even so, in the long term, the effect increases and its action begins as an anxiolytic.
- Neurological symptoms: there are also other direct complications on the nervous organ system. These would be lack of coordination, loss of balance, possible regional tremors, muscular spasms, etc.
- Other symptoms: increased appetite, weight, and even some localized pain, especially in the back.
In spite of all this, it is necessary to emphasize that most of the adverse effects are quite infrequent and do not limit the use of the medicine, for what we can affirm that, although they exist, it is possible that the drug is used without any problem. In a risk-benefit balance, it will always be better to use Lyrica.
How should I store or dispose of Pregabalin?
Let us remember that this is not a simple medicine like something you would normally take for fever, but it is a powerful drug that works for several things, but can seriously alter the brain if taken or used improperly. Therefore, it is necessary that you keep in mind several important recommendations before continuing to consume it.
First, keep it in its original packaging. Don't put it somewhere else, unless it's something fairly controlled (like a pill holder you take to work or something similar). Also, make sure it's tightly closed and well out of the reach of children. The doses you would normally take can be lethal to the youngest.
On the other hand, make sure you are in a place where there is not too much heat or humidity, such as a bathroom. You should place it in a cool environment, where conditions allow the integrity of the blister and tablets to be maintained.
Children can be very curious, so if you have pillboxes or are trying to leave the pills nearby to remember them, it's best to set an alarm and keep them as far away from your children as possible. The same goes for pets, of course. This dose can be processed quickly in the liver and become a lethal weapon that threatens the most loved ones.
On the other hand, it's important that you also understand that it's a medicine that you can't throw away anywhere. Many people are used to flushing it down the toilet, when the most important thing is to do it properly, with a special bio-security bag that tells you what you're throwing away.
Talk to the people responsible for trash or recycling so they can explain a little about the drug return program, which must exist in most communities worldwide. Pregabalin is an excellent medicine that can be used by those who need it.
Lyrica and Mental Disorders
Recently, we have witnessed the great social advance that our world has given. Not only in matters related to free thought, but also in matters of sexual deviations, the acceptance of certain diseases (HIV); even though there are still vestiges to cover.
The same has happened with the mental disorders, but progress seems to be slowing down. People say they "understand" what is happening and how it happens in a person with any psychiatric disorder, they really do not understand anything. This is, without a doubt, one of the most common problems in today's society, so we have a responsibility to learn to deal with these people, without underestimating what they are feeling.
It can be quite difficult to deal with a person with seizure disorders or who has severe neuropathic pain that really prevents them from moving on with their lives. this is where Lyrica comes in, as a viable option for restoring the order that person had long lost.
For this reason, pregabalin is considered a super-selective drug that can change the course of a patient's life with severe neurological pathologies. Without a doubt, pregabalin must be one of the most effective and best prescribed drugs in the world of modern medicine.
Features of the use of the most effective pharmacological agents for the treatment of neuropathic pain
|Medicine||Precautionary measures||Contraindications||Comments and recommendations|
|Gabapentin||Antacids may decrease bioavailability||Hypersensitivity||It is necessary to reduce the dose in renal failure and control body weight, especially in patients with diabetes|
|Selective Serotonin and Norepinephrine Reuptake Inhibitors|
|Duloxetine||Use with caution in patients with a history of mania, cramps, or bleeding; taking anticoagulants, tramadol or selective serotonin reuptake inhibitors||Concomitant use of monoamine oxidase inhibitors, uncontrolled arterial hypertension||It is necessary to control blood pressure in patients with hypertension or other cardiovascular diseases, especially in the first month of therapy. Smokers have half plasma concentration of duloxetine|
|Venlafaxine||Use with caution in patients with arterial hypertension taking tramadol or selective serotonin reuptake inhibitors||Monoamine oxidase inhibitors||Need to control blood pressure|
|Amitriptyline, nortriptyline, imipramine||Use with caution in patients with a history of seizures, prostatic hyperplasia, urinary retention, chronic constipation, angle-closure glaucoma, or increased intraocular pressure; with suicidal thoughts taking tramadol, selective serotonin reuptake inhibitors and selective serotonin and norepinephrine reuptake inhibitors||The recovery period after myocardial infarction, heart rhythm disturbance, especially cardiac conduction disturbance, concomitant use of monoamine oxidase inhibitors, porphyria||Patients over 40 years old are recommended to conduct ECG screening; with an increase in the dose of the drug, control of heart rate and blood pressure (measurement of both indicators in the supine and standing position); in patients taking drugs in a dose of more than 150 mg / day, ECG and blood counts are necessary. It is necessary to monitor body weight indicators, especially in patients with diabetes|
Anxiety Disorders: A Cruel Reality
Although things may seem different, it is only in this millennium that we are becoming more aware that there are non-organic diseases that can really alter the way we live, and for worse. And we're not just talking about the better known, like depression, but also about others that are less popular - but just as frequent - like anxiety disorders.
These are characterized by a constant fear that begins to change the way you think or do your daily activities to a point where you limit yourself and prefer not to move from where you are to having to face something that "could probably hurt you.
Anxiety disorders are various, not limited to just one, and their expression may be different depending on the type being studied. However, they are the best expression of the real connection that exists between the mind and our body. That for many centuries was being questioned.
What is the origin of the connection between body and mind?
There are many scientific studies that have shown that our mood can directly influence the way our body performs most of its metabolic functions.
For example, when we are stressed (psychologically), our body secretes an excess hormone: cortisol. What it does is that it increases blood pressure, muscle tension, causes headache, etc. And these, in turn, are the symptoms we often associate with being stressed.
On the other hand, when people are happy they secrete many endorphins. These small molecules, also called happiness hormones, are able to change our immune status. That is to say, they can reinforce and increase the expression of the molecules and immunological mediators necessary to be able to defend ourselves.
The same thing happens with anxiety, but at much higher levels in some cases. It can range from mild preventative behaviors that only require psychotherapy, to other more serious disorders that need rescue treatment.
Types of Anxiety
As we said from the beginning there are several types, but we are going to limit ourselves to those that are more frequent and important. Among them we have:
One of the main ones, when we talk about avoidance behaviors, is agoraphobia. Although the concept has changed a lot over time and before it was believed that this problem had to do with fear of public spaces or with many people, today we know that this is not the case.
Specialists affirm that agoraphobia is the inability to be alone in a public or open space. According to them, those patients who are accompanied if they can stay in such places without major problems. The recommended treatment is psychotherapy, although other measures may be necessary depending on the severity of the condition.
This is one of the most delicate manifestations of anxiety disorders. It is the one that is most related to that strong connection between our emotions and feelings and the state of our organism.
Panic disorders are characterized by recurrent panic attacks. These are powerful biological manifestations of a strong fear or aversion, but in order to understand it better, let's put things a little more in context.
Imagine you are walking down the street, back from the super market, and suddenly you have an unexplainable feeling that forces you to sit down to cry and scream for no apparent reason, where your heart rate increases, your chest hurts, your head, and you feel that the world is crushing you. No fun, right?
This is what happens during panic attacks. Although sometimes there may be some treatable underlying cause (such as possible mild meningitis), you most often need psychotherapy and some special drugs, such as serotonin reuptake inhibitors, to be able to return to your normal life without major complications.
It is necessary to mention that the drugs are not always effective with the first attempt, so you may need to be under the exposure of serotonergic for much more than a week. Most specialists say that after 3 weeks you will begin to see the real effects, so it may be necessary to wait a little longer.
Also, during panic attacks, the only thing doctors can give you are benzodiazepines, which can mitigate and calm most of the symptoms associated with this disorder. Still, this is something that can only happen in a hospital or clinic, so it's hard for it to happen.
Another of the disorders, which also greatly impedes common life, is generalized anxiety. In this case, the condition has a much greater psychological implication than the previous one. What happens is that we live with a fear that forces us to maintain preventive behaviors, but in this case the fear is broad and constant.
For example, we may be afraid to cross a specific street. But not just any fear, but one that paralyzes you and simply won't let you continue. What we do is create a behavior that forces us to avoid what frightens us. In this case, we would look for a route to our destination that does not imppique cross that street.
This is what happens in generalized anxiety disorder. People have to start creating different behaviors that can exempt it from what they are currently living. So the lifestyle changes a lot and we are limited to doing what we are not afraid of.
While there are many types of phobias, we are going to create two large groups: social phobias and specific ones. These share something in common, which is an irrational fear that can only be overcome -in most cases- through psychotherapy.
The first is social phobia, characterized by the inability to maintain or generate new interactions with other people, but it can also include the irrational fear of being in a place with too many people, or being the center of attention in some way.
Finally, there are also specific phobias. These are more punctual and limited only to one point. For example, phobia of frogs, sea, water, etc.
Neuropathic Pain: Treating to Improve your Life
Neuropathic pain comes from injury or alterations in the functioning of our nervous system, which is responsible for perceiving and interpreting all stimuli that come from outside (through touch, smell, etc.). In this case, stimuli that seem normal end up being perceived as very painful sensations.
The same nervous system that should protect you and help you understand the world, self-decepts, and you end up only with pain.
This term arises to name a specific type of pain that, while generated by the nervous system (either central or peripheral, appears without there really being a clear trigger. Of course, unlike the rest of the common perceptions and sensations, this one has no use; it is a disease.
Let's give a quick example. Imagine that you are gently knocking on the door with your fingertips. Under normal conditions, this would not be enough to trigger a painful response, however, those who suffer from neuropathic pain may experience pain as severe as a severe burn just by knocking on the door.
Why Does Neuropathic Pain Appear?
Although it is a disorder of the nervous system as we have explained before, the physiopathology behind this disease is what we find interesting. Under normal conditions, we have several receptors in charge of perceiving pain, which protects us, alerts us and defends us from blows or possible burns. These are called nociceptive receptors.
Under normal conditions, these receptors have a standard stimulation that responds gradually to the type of stimulus being performed. However, in the case of neuropathic pain there is some non-physiological alteration that is causing an exaggerated response of these receptors, releasing many more mediators and giving our brain to understand that we are undergoing suffering, when the truth is that we are not.
How do I know if I have Neuropathic pain?
Although it's still just "pain," the truth is that it can be expressed in different ways. For example, most people who suffer from it say that they perceive a burning pain or very intense cold, which is usually accompanied by some tingling but is very intense, like an electric shock.
On the other hand, there may be simple hyperalgesia, the same sensation of common pain that we all have, but much worse than what we are used to. It's also known as allodynia, a disorder that impedes people's normal routine.
When severe symptoms appear, when reactions are due only to hyperalgesia that goes beyond normal, specialists say that there must be a frank alteration of all the circuits responsible for the transmission of pain, which means that the treatment and control of pain can be very complicated.
On the other hand, when the processes are not centralized like the previous example, but, on the contrary, have to do with altered reactions and perceptions that are regional, the treatment is more effective, and the diagnosis is much more precise.
Some examples of this last peripheral alteration would be stenosis of the lumbar canal, problems with sciatica, Suddeck Dystrophy, diabetic polyneuropathy, trigeminal neuralgia, etc. There are several pathologies that by themselves are complicated, but the treatment of the neuropathic pain they cause is a little simpler and more effective.
Patients may also have neuropathic pain from severe traumatic injuries or when amputations are performed. Even some common syndromes (such as carpal tunnel syndrome) may cause neuropathic pain without warning.
In even rarer cases, frequent chronic illnesses may cause this type of pain. We may be talking about cardiovascular disorders, such as stroke or uncontrolled high blood pressure, as well as cancer or others.
It is not an easy thing to diagnose neuropathic pain. The only people who are truly capable of diagnosing this type of pathology are specialist doctors, not even primary care doctors. Even so, there are several specialized units to care for patients with pain, in which you may find the answer.
As mentioned above, treatment of this disease can be quite complicated. The best thing, as always, will be to implement the relevant measures in a timely manner so that this disease can be tackled effectively. The more time passes, the easier the diagnosis will be, but the more difficult it will be to treat it.
Not in all cases is able to completely relieve the pain in this type of disorder. In fact, many times several therapies are needed at the same time, involving traditional measures of medicine with other not so traditional ones, in order to apply this symptom.
As you may have noticed, we are only talking about treating pain, because many times the cause is not treatable. Of course, in cases where the cause is treatable, the first thing to do is to use appropriate therapies to mitigate the origin. However, when this is not possible, we should progress to a plan B that is a little more elaborate.
Within the available treatments we have:
- Antidepressants: Although their name indicates other things, these drugs can also alter the way nerves transmit information. It doesn't mean that it will diminish depressive or similar symptom in your mind, but that it will prevent the "pain" information from being carried to your brain, and that way we will avoid feeling it.
- Antiepileptics: among the most used are also anticonvulsants, including gabapentin, pregabalin, topiramate and carbamazepine. Undoubtedly, although this treatment works as an adjuvant, it is quite effective in relieving pain in most cases. Even so, we must be quite attentive to any adverse effects.
- Analgesics: almost anything can be tried. From some minor opioids, such as tramadol, to some major opioids, such as oxycodone. You might even use local anesthetics like topical lidocaine in patches, which has proved to have a good margin of efficacy.
If you think you have neuropathic pain, we recommend that you consult your trusted doctor for the treatment you need. Do not self-medicate. In a very high percentage of cases, this disorder has a solution.