Lyrica and gabapentin are being increasingly prescribed for many chronic pain conditions, in part because of concerns about opioids. However, these medications have serious side effects of their own and they are not very effective. There are better alternatives.

What the research says about Lyrica and Gabapentin

Lyrica (pregabalin) and gabapentin (Neurontin) are in a class of drugs called gabapentinoids. The FDA has approved gabapentin only for the treatment of postherpetic neuralgia (post-shingles pain) and pregabalin for postherpetic neuralgia, fibromyalgia and neuropathic pain associated with diabetes or spinal cord injuries. However, both are frequently prescribed for all kinds of pain, including sciatica, back pain, burn injury and arthritis, despite the lack of evidence that they are effective for those conditions.

Prescriptions for gabapentinoids have tripled in the last 15 years and they are among the best selling, highest grossing drugs in the U.S. However, many concerns are being raised about their use. There have been a total of 426,000 adverse event reports to the FDA about gabapentin between 2004 and June 2015, of which 50,000 were reports involving death and over 150,000 involved hospitalization. For Lyrica, there have been 335,855 adverse event reports during the same time period, with about 23,000 involving death and about 90,000 involving hospitalization. It is generally accepted that since most adverse event reporting is voluntary, only about 1% of less serious side effects and only about 10% of serious side effects are reported.

A study published in the British Medical Journal (BMJ) in June 2019 found that “gabapentinoids are associated with an increased risk of suicidal behaviour, unintentional overdoses, head/body injuries, and road traffic incidents and offences. Pregabalin was associated with higher hazards of these outcomes than gabapentin”. Another serious concern is that gabapentinoids may block new synapse formation in the brain. This may be the reason for the frequent reports of impaired cognitive performance by patients taking these drugs.

Other commonly reported side effects include dizziness, sleepiness, balance problems, blurred vision, coordination problems, nausea, vomiting, diarrhea, headaches, increased pain (including pain in extremities, back pain and joint pain), depression, anxiety and insomnia.

What patients report about Lyrica and Gabapentin

A 2014 survey by the National Pain Report of patients with fibromyalgia found Lyrica to be “very effective” in only 10% of patients. Another 29% reported that it “helps a little”.

Patient reports on askapatient.com are mostly very negative, with many reporting horrible side effects that didn’t always remit when they stopped taking gabapentinoids. Those who tried to stop the medications reported that the withdrawal was very severe.

Here are a few patient reports from askapatient.com:

From a 30 year old male prescribed Lyrica for fibromyalgia:

Bad initial side effects when I started in 2012, extreme headaches, can still remember them clearly and extreme fatigue, I would literally sleep for 20 hours and wake up for an hour and then start the process again, this went on for months and no one knew what was wrong with me. So going forward to 2019, I have had 29 surgery’s since then, abscess all over my body, head to toe and only after recently watching a documentary about junkies, it’s the same as what junkies and meth heads get. I have been trying to get off this medication for about a year now and am down to the final 150mg, however even doing withdrawal over this period is a waste of time as when you get to the final 150mg, all the symptoms start again and it’s a bad balancing game Don’t take unless you’re happy to be on it for life with horrible side effects … I look like the elephant man some days, I haven’t had a normal life in years…. I wouldn’t be as pissed off if I hadn’t had a single abscess until I started taking the Pregabalin, not one doctor to this date has put two and two together…. I have had a few significant mental breakdowns and again nothing before the pregabaline use.

From a 38 year old female prescribed Lyrica for fibromyalgia:

Side effects included burning pain, pins and needles, blurred vision, feeling too high to drive, constipation, manic, rash. Stopping this drug has given me unbelievable pain. Involuntary muscle movements, pins and needles and buzzing, weakness, brain zaps, spasms, twitches, and more. I took my last pill 10 days ago and it’s still going on. Couldn’t get out of bed for 4 days. Pure poison.

From a 43 year old female taking Lyrica for L4, L5, SI injury and nerve pain:

Side effects included leg swelling, dizziness, headaches, aggression, extreme nerve pain if I was late taking the med. This stuff is the devil. And coming off of it was worse than being on it.

From a 61 year old female prescribed gabapentin for fibromyalgia:

Exacerbated my fibromyalgia pain, extremely exhausted all the time, extreme dry mouth and throat (which affected my vocal chords), severe depression and lethargy, poor memory, heart palpitations, could not walk any significant distance. This is a very dangerous medication and doctors do not recognize the side effects and tend to prescribe additional meds to ease symptoms.

Read more patient reports about these and other drugs at askapatient.com.

There are safer, more effective alternatives to Lyrica and gabapentin

Warning!!! If you are currently taking these drugs, do not stop abruptly! It can be life-threatening. Taper slowly under a doctor’s supervision. Experts recommend no more than a 10% reduction per month.

Medical marijuana

Medical marijuana is currently legal in 33 states and the District of Columbia. Marijuana grows wild in all but the coldest climates around the world and has been in medicinal use for at least 5000 years. Marijuana was widely used in pharmaceuticals in the U.S. until 1941, when it was banned. Not a single death has ever been attributed to marijuana use. There are minimal side effects and those tend to be mild and transitory, though caution is advised in use of those under 21 years of age and pregnant women due to concerns about effects on brain development.

The most common condition for which marijuana is used medically is chronic pain, including neuropathy, fibromyalgia and back pain. Minimal research has been done in the U.S. due to severe federal restrictions, however what research there is indicates that marijuana does reduce pain. In the National Pain Report survey of fibromyalgia patients referenced above, 62% of patients said marijuana was very effective in treating their symptoms and 33% said it helped a little. A survey of 100 consecutive medical marijuana patients who were returning for their annual recertification in Hawaii found that 97% used marijuana primarily for relief of chronic pain. They reported an average 64% decrease in pain—a decrease on a 10-point pain scale from 7.8 to 2.8.

Marijuana also helps with insomnia, anxiety and seizure disorders. It also helps minimize opioid withdrawal symptoms and some states have approved it for treating opioid use disorder. Some patients also report that marijuana has helped them with withdrawal from gabapentinoids, though a slow taper is still necessary.

You don’t have to smoke marijuana or get high in order to get pain relief. Besides smoking, marijuana can be taken in edibles, used as an oral tincture or used in topical preparations. It can also be vaped, a process of heating the marijuana just enough to release the vapors but not enough to burn the leaves. Vaping thus reduces the irritants that are inhaled. Marijuana also comes in many strains, with varying amounts of the psychoactive ingredient, THC, that produces the high. It is possible to get a marijuana strain that is low enough THC that it has pain-relieving effects without producing a high.

CBD (Cannabidiol)

CBD is one of the compounds found in marijuana. It is also found in hemp, which, like marijuana, is a member of the cannabis species of plants. Hemp does not contain THC and CBD products are derived from hemp rather than marijuana. They are federally legal in all states.

CBD and other compounds found in the hemp plant, including flavonoids and terpenes, have pain-relieving qualities and many patients find they get adequate pain relief from using them. Using CBD without the THC has even fewer side effects. Many experts believe, however, that THC and CBD in combination yield the best pain-relieving effects because the synergy of the two is better than either alone.

Kratom

Kratom was until recently a little-known herb that is grown in Southeast Asia. It has been used medicinally in Asia for hundreds of years. It is rapidly gaining in popularity among pain patients in the U.S. who are interested in alternatives to pharmaceuticals.

Kratom is even less researched than marijuana. It has many similar effects. These include pain relief, anxiety reduction, help with sleep and help with opioid withdrawal. Some patients also report that Kratom helps with withdrawal from gabapentinoids.

Kratom is much less expensive than marijuana and also less palatable. It is usually taken orally and has a bitter taste. Kratom, like marijuana, comes in different strains. Some strains are more stimulating and are used early in the day to boost energy. Others are more sedating and used later in the day for relaxation and sleep.

The FDA is currently trying to ban kratom on the basis that it is highly addictive and has caused a few dozen deaths. Kratom is actually a member of the coffee family and experts have stated that it is no more addictive than caffeine. All of the people who have died with kratom in their system also had other drugs in their system that could have caused the death, including opioids. The FDA’s most recent efforts to end access to kratom included trying to convince the Indonesian government to ban export of kratom. 95% of the kratom available in the U.S. comes from Indonesia.

Homeopathy

Homeopathy is another little known and vastly underutilized therapy for chronic pain. Homeopathy is a system of medicine developed in 1827 by a German physician, Dr. Samuel Hahnemann. It was wildly popular in the U.S. until it was quashed by pharmaceutical company interests in the early 1900s. At the time there were 44 homeopathic medical schools and more than 100 homeopathic hospitals in the United States. Homeopathy remains popular in Europe, though there have been recent attempts to end its practice there.

Homeopathy is based on the principle that “like cures like.” This means that any substance capable of producing symptoms in a healthy person can cure similar symptoms in a person who is sick. This idea is referred to as the “law of similars.”

A second homeopathy principle is that you should administer the least amount of medicine necessary to evoke a healing response. This is called the “minimum dose.” To prevent side effects, Hahnemann began successive dilution with shaking his medicines to find the point at which they would be therapeutic but not toxic. He also discovered that in many situations the best cure was achieved by the highest possible dilution. Homeopathic remedies can be taken orally or used in topical ointments.

Homeopathy has been controversial partly because homeopathic medicines in high potencies are so diluted that theoretically there should be no measurable remnants of the starting materials left. In a 2010 study, researchers demonstrated for the first time the presence of nanoparticles of the original substance in these extreme homeopathic dilutions.

Ideally, homeopathic remedies are chosen with the help of a trained practitioner, who looks at the presenting symptoms from a holistic perspective. However, many patients use homeopathic remedies successfully to address specific symptoms. Some homeopathic remedies commonly used for pain are arnica montana for muscle soreness and bruises, hypericum for nerve pain and ruta graveolens for inflammation, strains and sprains. A common potency is 30x.

There are also homeopathic creams and ointments, such as Traumeel, a combination remedy, for topical pain relief.

Since homeopathic remedies are not toxic, it is safe to try them on your own. I have used them for decades with good results as a substitute for NSAIDs, which have safety risks of their own. They are very inexpensive, another plus.

VoxxLife Socks and Insoles

Another novel and little-known treatment that helps with neuropathy and fibromyalgia is VoxxLife Socks and insoles. These have a pattern that stimulates neuropoints on the ball of the foot that affect the mid-brain, increasing balance, stability, strength, range of motion, flexibility and mobility. Their website contains many video testimonials of pain patients who have benefitted from their use.

There is so much more

There are so many other therapies that safely and effectively help with fibromyalgia, neuropathy and other types of chronic pain. These include acupuncture, biofeedback, physical therapy, massage, mind/body medicine, pulsed EMF, low level laser therapy, and more. You can find out about all of these therapies and find providers and products on the Alternative Pain Treatment Directory.

Cindy Perlin is a Licensed Clinical Social Worker and chronic pain survivor. She is the founder of the Alternative Pain Treatment Directory and the author of The Truth About Chronic Pain Treatments: The Best and Worst Strategies for Becoming Pain Free.

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