Pregabalin Rectifies Aberrant Brain Chemistryń

Brain imaging reveals dynamic changes caused by pain medicines | University of Michigan Health System – University of Michigan – 2013 (no longer available online in 2019. This is a repost with new relevance)

…the implication is that at least one factor in chronic pain can now be visualized by computer imaging.  Pregabalin (Lyrica) soothes the insula, and the changes in insula activity and corresponding decreasing pain levels were made visible for the first time.

So far, we’ve only had static images of brains to compare those of people with chronic pain to those who are pain-free, but now we can compare the changes as they happen in a single individual. 

Nerve Pain Drugs Linked To Serious Risks

Common Nerve Pain Drugs Linked To Suicide, Other Serious Risks | The Fix – By Kelly Burch 06/20/19

These are the drugs that the anti-opioid crusaders would prefer we take instead of opioids, which only demonstrates their ignorance about medication and chronic pain.

A new study found that Lyrica and similar nerve pain meds were associated with increased suicide risk as well as unintentional overdose and traffic accidents. 

The popular prescription drug Lyrica and similar drugs that are used to treat muscle and nerve pain have been linked with suicidality, accidental overdose and increased risk of serious accidents, according to a new study.   

Abuse Potential of Gabapentin & Pregabalin

Special Report: The Abuse Potential of Gabapentin & Pregabalin – By Max Buscaglia, PharmD Candidate, Haley Brandes, PharmD Candidate and Jacqueline Cleary, PharmD, BCACP – June 2019

The inevitable dark side of these “preferable to opioids” medications is becoming harder to ignore:

Key Takeaways:

Gabapentinoid abuse may rise as the prescribing and use of opioids decreases, but the biggest concern may come when these agents are combined with other prescribed medications or illicit street drugs.   

Cochrane Reveiws of Gabapentoids to Relieve Pain

Here are some Cochrane reviews on the efficacy (or lack thereof) of gabapentin (Neurontin) and pregabalin (Lyrica):

• Gabapentin for Chronic Neuropathic Pain
• Pregabalin for Fibromyalgia
• Pregabalin for Acute and Chronic Pain in Adults
• Pregabalin for Chronic Neuropathic Pain in Adults

These medications seem mildly effective for their FDA-approved conditions, but much less so for chronic pain. Yet… I’ve found Lyrica helpful for episodic pain flares when I take it on an “as needed” basis.

Scant Evidence Gabapentin Works for Pain

Millions Take Gabapentin for Pain. But There’s Scant Evidence It Works. – The New York Times – By Jane E. Brody – May 20, 2019

“There is very little data to justify how these drugs are being used and why they should be in the top 10 in sales,” a researcher said.

One of the most widely prescribed prescription drugs, gabapentin, is being taken by millions of patients despite little or no evidence that it can relieve their pain.

In 2006, I wrote about gabapentin after discovering accidentally that it could counter hot flashes. [that article is posted below]   

CDC Guideline Protest Letter Signatories

SUPPORTERS’ SIGNATURES and COMMENTS – Sep 2018

Health Professionals Call on the CDC to Address Misapplication of its Guideline on Opioids for Chronic Pain through Public Clarification and Impact Evaluation

Individuals wishing to register their solidarity with this effort, who are not health professionals, should sign on this page.

This document has 129 pages of signatories and their comments. I tried to clean it up a little, but I had to stop part way because it’s just too long. I’ve posted it here just in case the original Google Doc disappears.

You may enjoy, like I did, finding out how many medical professionals are protesting and how many pain patients are scattered all across America suffering from their individual burdens of pain. 

Patients’ Experience With Opioid Tapering

Patients’ Experience With Opioid Tapering: A Conceptual Model With Recommendations for Clinicians – free full-text article from Journal of Pain – Feb 2019

I found this an interesting read because it describes different ideas and experiences with tapering. I’m encouraged because it’s only a part of a larger study collecting data on the outcomes of opioid tapers, data we desperately need to hold the CDC accountable for the misery and deaths its guideline caused.

Abstract:

Clinical guidelines discourage prescribing opioids for chronic pain, but give minimal advice about how to discuss opioid tapering with patients.

We conducted focus groups and interviews involving 21 adults with chronic back or neck pain in different stages of opioid tapering.  

Complex Chronic Pain Disorders

Complex Chronic Pain Disorders – By Don L. Goldenberg, MD – Feb 2019

The pathophysiology of and approaches to 3 commonly seen pain conditions: CRPS, EDS, and SFN.

• Complex regional pain syndrome (CRPS),
• Ehlers-Danlos syndrome (EDS), and
• small fiber neuropathy (SFN)

are three important and complex chronic pain disorders.  

Alternatives to Opioids in Medication for Pain

Alternatives to Opioids in the Pharmacologic Management of Chronic Pain Syndromes: A Narrative Review of Randomized, Controlled, and Blinded Clinical Trials – free full-text /PMC5785237/ – 2018 Nov

This recent review finds that there is very little evidence beyond a few weeks for the “effectiveness” [see qualification at end of review] of any non-opioid medication that has some beneficial effect on pain.

The goal of this review was to report the current body of evidence-based medicine gained from

• prospective,
• randomized-controlled,
• blinded studies

on the use of non-opioid analgesics for the most common non-cancer chronic pain conditions.   

The Involvement of Epigenetics in Chronic Pain

Chronic Pain: Emerging Evidence for the Involvement of Epigenetics – free full-text /PMC3996727/ – Apr 2013

Abstract

Epigenetic processes, such as histone modifications and DNA methylation, have been associated with many neural functions including synaptic plasticity, learning, and memory.

Here, we critically examine emerging evidence linking epigenetic mechanisms to the development or maintenance of chronic pain states.

Although in its infancy, research in this area potentially unifies several pathophysiological processes underpinning abnormal pain processing and opens up a different avenue for the development of novel analgesics.