Because I’m plagued by anxiety, I’m always interested in any unorthodox methods of dealing with it. While “benzos” would work for the immediate problem, I can’t (and am not allowed to with my opioids) take them all the times I’m anxious.
With all my researching, I’m surprised to discover that I missed a solution that seems obvious in retrospect: the Lyrica I’m prescribed, which I take on an “as needed” basis for a certain kind of pain, can also act as an anti-anxiety medication.
Here are a couple of PubMed abstracts showing that Lyrica (pregabalin) has been evaluated for anxiety for years already:
Pregabalin is an alternative compound to SSRIs and SNRIs for the first-line treatment of generalized anxiety disorder (GAD).
We describe the pharmacokinetic properties of pregabalin and their implications for the treatment of GAD.
A search in the main database sources (Medline, ISI, Web of Knowledge and Medscape) was performed in order to obtain a comprehensive and balanced evaluation about the clinical implications of the pharmacokinetic properties of pregabalin in the treatment of GAD. The word “pregabalin” was associated with “pharmacokinetics”, “interactions”‘, “GAD”, “anxiety” and “tolerability”. No restriction criteria were established in relation to methodology or publication year. Only English-language articles were selected.
On the other hand, prescription of pregabalin should be handled with caution to minimize the incidence of renal impairment (especially in elderly patients), where a history of substance misuse or concomitant medications (e.g. anti-hypertensives or some antibiotics) are risk factors that can affect renal function.
Pregabalin is a safe and efficacious compound for GAD treatment.
Short half-life (preventing persistence of side effects), absence of active metabolites and no interactions with CYP450 enzymatic system are all favorable pharmacokinetic properties for the treatment of GAD patients, including those with comorbid depressive symptoms or medical conditions.
That last sentence makes it sound like this would be the perfect answer for me because I definitely have comorbid “depressive symptoms” (why do they call it a symptom, not a disease?) and a medical condition, EDS.
And this study from 4 years ago evaluated Lyrica versus Zolot (SSRI):
Generalized Anxiety Disorder (GAD) is a chronic mental illness with a prevalence of 5-7% in the general population.
GAD is characterized by extreme persistent worry, mostly about minor problems, involving pathological fear with high occurrences of vegetative disturbance.
For me, my anxiety feels more like dread: I dread every next moment when something terrible is sure to happen, something I will have caused or not prevented, something that I will have to fix even though I won’t be able to.
According to the guidelines of the World Federation of Societies of Biological Psychiatry (WFSBP), the first-line treatments for GAD are
- Serotonin selective reuptake inhibitors (SSRIs),
- Selective serotonin- and norepinephrine reuptake inhibitors (SNRIs) and
- pregabalin, an atypical anxiolytic.
In this study, both efficacy and tolerability of pregabalin were evaluated and compared with efficacy and tolerability of sertraline, an SSRI antidepressant.
PATIENTS AND METHODS:
107 patients both male and female, aged 20-60 were included in the study. Patients fulfilled criteria for GAD, according to ICD-X and DSM-IV.
Each patient was randomly assigned to 4 weeks of treatment with pregabalin (n=47) or sertraline (n=60).
Both pregabalin and sertraline showed good results in treating symptoms of Generalized Anxious Disorder.
The onset of action was shorter in treatment with pregabalin compared to the treatment with sertraline.
In the patients treated with sertraline, the anxiolytic effect was detectable after at least 14 days while pregabalin showed initial good results during the first week of treatment.
Adverse effects were reported in 28% patients treated with pregabalin and 27% of patients treated with sertraline, without significant differences.
There were no drop-out patients in neither group. Beside pharmacotherapy, each patient received 8 weeks of cognitive/behavior therapy. In concomitant therapy benzodiazepine was used (klonazepam, in low doses).
In all patients adverse events were short-lasting withmild intensity and there were no withdrawal events during this study.
Efficacy and tolerability of pregabalin were high.
Compared to sertraline, pregabalin showed more rapid onset of action and equal efficacy. Adverse reactions are short-lasting and the dose depends.
Our investigation showed that pregabalin, an atypic anxiolytic is efficient and well tolerable in treatment of GAD.