Lyrica may increase incidence of birth defects

Exposure to Pregabalin During the First Trimester Leads to Increased Incidence of Major Birth Defects

Yet, the CDC is forcing pain patients to use new risky drugs like this rather than opioid medications. 

These drugs have only been around a few years and it’s far too early to know what long-term effects they may have.  Only known side effects have been tested for in the short time they’ve been in use.

By comparison, opioids are actually much safer and most importantly, much more thoroughly studied during much more time.

Taking pregabalin during the first trimester may increase incidence of major birth defects  

Exposure during the first trimester of pregnancy to pregabalin (also known as Lyrica), a drug commonly prescribed to manage neuropathic pain, pain resulting from shingles, spinal cord injury or fibromyalgia, and which is also administered in combination with other medications to treat certain types of seizures in epileptic patients, has recently been implicated in a study published in Neurology, with an increased occurrence of birth defects.  

Below is the hardcore technical description of how Lyrica is thought to work

Although a structural derivative of the neurotransmitter GABA, pregabalin does not bind to GABA or benzodiazepine receptors, but its prolonged application to rat neurons in culture results in increased density of the GABA transporter protein, GAT1 and in increased rate of GABA transport

Pregabalin does not bind to opiate, serotonin or dopamine receptors, nor does it affect cyclooxygenase acitivity

It is thought that its anti-nociceptive and anti-convulsant properties are conferred by and mediated through its specific binding to the α2δ subunit of voltage-gated calcium (Ca2+) channels in the CNS3. Binding of gabapentin to Ca2+ channels reduces influx of Ca2+ into neurons, resulting in a reduction of glutamate release from synaptic terminals and reduced activation of substance P-mediated activation of AMPA receptors on noradrenergic synapses, leading to decreased neuronal activity.

End of super technical part of this article.

Several animal studies reported developmental toxicity of pregabalin, with occurrence of teratogenic effects5, skeletal malformations, growth retardation, neural tube defects, lethality, reproductive system impairments, and behavioral abnormalities

For this study, data was collected from 8 Teratology Information Services in 7 European countries between 2004 and 2013.

  • 77% of patients in the pregabalin group started treatment before pregnancy, discontinuing it at a median of 6 weeks of gestation;
  • 61% of patients continued beyond 6 weeks, and
  • 33% beyond 7 weeks of gestation.

Exposure to pregabalin during the first trimester of pregnancy was observed for 96% of patients within this group, with a median duration of exposure of 6 weeks, and a median daily dose of 150 mg.

Major birth defects (MBD) were more frequent in pregabalin-exposed pregnancies than in controls (9.6 vs 2.8, p<.001), and so were pregnancy terminations (9,8 vs 5.0%, p=.02 for elective terminations; 5.5 vs 1.8%, p=.008 for medical terminations), resulting in a lower rate of live births in pregabalin pregnancies (71.9 vs 85.2%, p<.001).

References

  1. Winterfeld U, Merlob P, Baud D, et al. Pregnancy outcome following maternal exposure to pregabalin may call for concern. Neurology. 2016;
  2. Whitworth TL, Quick MW. Upregulation of gamma-aminobutyric acid transporter expression: role of alkylated gamma-aminobutyric acid derivatives. Biochem Soc Trans. 2001;29(Pt 6):736-41.
  3. Stahl SM, Porreca F, Taylor CP, Cheung R, Thorpe AJ, Clair A. The diverse therapeutic actions of pregabalin: is a single mechanism responsible for several pharmacological activities?. Trends Pharmacol Sci. 2013;34(6):332-9.
  4. Wedekind D, Bandelow B. [The alpha2delta subunit of the voltage-dependent calcium channel. A new pharmaceutical target for psychiatry and neurology]. Nervenarzt. 2005;76(7):888-91.
  5. Etemad L, Mohammad A, Mohammadpour AH, Vahdati mashhadi N, Moallem SA. Teratogenic effects of pregabalin in mice. Iran J Basic Med Sci. 2013;16(10):1065-70.
  6. FDA highlights of prescribing information for Lyrica: http://www.accessdata.fda.gov/drugsatfda_docs/label/2012/021446s028lbl.pdf

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