Addiction - Lyrica(pregabalin) problem

[Man5onite]

Swim has had a lot of good times with Lyrica, either alone or in combination, in varying doses, usually 1200-1800mg. For Swim it is great, he gets stimulation/sedation/euphoria, kind of like Kratom

Now Swim i prescribed this for anxiety and backproblems, but that shit is taken care of and Swim just uses it for fun.

The thing is that Lyrica is not controlled substance in Norway, so the Dr's/nurses don't think twice about writing a prescription or calling one in to the pharmacy. Basically Swim can get as much as he wants.

There lies the problem, Swim now uses them in exceedingly high doses on a regular basis, sometimes up to 9000mg a day.
And it has started to get Swim easily irritated, a bit manic, talks alot(think like mildly intoxicated by alc.),says things he later regrets and snaps a lot to people. People have started to confront Swim that he changed for the worse, when in the beginning when he used smaller doses people thought he changed for the better.
About 36hours after Swim takes his last dose he gets withdrawals (sweating, intense panic, suddenly very cold then hot,cravings for the sweet feeling of Lyrica, shaking, feels very depressed and unable to function socially at all)

Swim knows he is rambling, but he just wanted to (poorly) document Lyricas recreational and addictive qualities.
And if someone with good knowledge of CNS drugs would say if this is dangerous, Swim often wonders if this may be damaging to his health in the long-term.
It IS a poorly studied drug.

Love to you all

[Jatelka]

Can't really find very much about pregabalin abuse/dependency etc.

This is copy n pasted from the DEA website:

"
SUMMARY: This final rule is issued by the Deputy Administrator of the Drug Enforcement Administration (DEA) to place the substance pregabalin [(S)-3-(aminomethyl)-5-methylhexanoic acid], including its salts, and all products containing pregabalin into Schedule V of the Controlled Substances Act (CSA). As a result of this rule, the regulatory controls and criminal sanctions of Schedule V will be applicable to the manufacture, distribution, dispensing, importation and exportation of pregabalin and products containing pregabalin.

SUPPLEMENTARY INFORMATION:
Background
On December 31, 2004, the Food and Drug Administration (FDA) approved pregabalin [(S)-3-(aminomethyl)-5-methylhexanoic acid] for marketing under the trade name LyricaTM. LyricaTM will be marketed in the United States as a prescription drug product for the management of neuropathic pain associated with diabetic peripheral neuropathy (DPN) and postherpetic neuralgia (PHN). Pregabalin has recently been placed on the market in some European countries for the treatment of epilepsy and neuropathic pain.

On April 4, 2005, the Acting Assistant Secretary for Health of the Department of Health and Human Services (DHHS), sent the Administrator of the DEA a letter recommending that pregabalin, and its salts, be placed into Schedule V of the CSA. Enclosed with the April 4, 2005, letter was a document prepared by the FDA entitled, ``Basis for the Recommendation for Control of Pregabalin in Schedule V of the Controlled Substances Act (CSA).'' The document contained a review of the factors which the CSA requires the Secretary to consider

Based on the recommendation of the Acting Assistant Secretary for Health and an independent review of the available data by the DEA, the Deputy Administrator of the DEA, in a May 13, 2005, Federal Register Notice of Proposed Rulemaking , proposed placement of pregabalin into Schedule V of the CSA. The proposed rule provided an opportunity for all interested persons to submit their comments, objections or requests for hearing to be received by the DEA on or before June 13, 2005.

Comments Received

The DEA received two comments in response to the Notice of Proposed Rulemaking. One commenter stated that the DEA should not minimize the similarity in effects produced by pregabalin and diazepam and should place pregabalin in Schedule IV of the CSA.

The DEA does not agree. Careful consideration of all the available data suggests that pregabalin has less abuse potential than Schedule IV substances. Pregabalin does not substitute for benzodiazepines in benzodiazepine-dependent animals. Data from clinical trials suggest that some of pregabalin's positive psychic effects are limited and do not continue with time or continued drug use. The data are consistent with a substance that could be abused intermittently for reward, but not for reinforcement. In addition, withdrawal effects of pregabalin are less severe than with other substances currently controlled in Schedule IV.
Another commenter stated that, in their experience with pregabalin in clinical trials, pregabalin does not demonstrate any risk that would merit being considered a scheduled drug.

The DEA does not agree. Preclinical studies indicated that pregabalin is transiently and sporadically self-administered at rates greater than vehicle but substantially lower than active comparators pentobarbital (CII) and methohexital (CIV). In clinical trials, pregabalin produces some pharmacological effects characteristic of diazepam and alprazolam and is likely to be abused for its positive psychic effects. The percentage of individuals that experienced acute euphoric effects was unusually high for pregabalin in clinical trials. Pregabalin also produced dizziness, somnolence, dry mouth, edema, blurred vision, weight gain and attentional problems more frequently than placebo. These data suggest that pregabalin does have sufficient abuse potential to warrant control under the CSA. The DHHS recommended control in Schedule V of the CSA and the DEA concurs.

Scheduling of Pregabalin

Relying on the scientific and medical evaluation and the recommendation of the Acting Assistant Secretary for Health, received in accordance with section 201(b) of the Act , and the independent review of the available data by the DEA, and after a review of the comments received in response to the Notice of Proposed Rulemaking, the Deputy Administrator of the DEA, pursuant to sections 201(a) and 201(b) of the Act, finds that:

(1) Pregabalin has a low potential for abuse relative to the drugs or other substances in Schedule IV;

(2) Pregabalin has a currently accepted medical use in treatment in the United States; and

(3) Abuse of pregabalin may lead to limited physical dependence or psychological dependence relative to the drugs or other substances in Schedule IV.

Based on these findings, the Deputy Administrator of the DEA concludes that pregabalin, including its salts, and all products containing pregabalin, warrant control in Schedule V of the CSA."

Some other titbits (will try to find the full studies

LYRICA is not known to be active at receptor sites associated with drugs of abuse. As with any CNS active drug, physicians should carefully evaluate patients for history of drug abuse and observe them for signs of LYRICA misuse or abuse (e.g., development of tolerance, dose escalation, drug-seeking behavior).

Abuse
In a study of recreational users (N=15) of sedative/hypnotic drugs, including alcohol, LYRICA (450mg, single dose) received subjective ratings of "good drug effect," "high" and "liking" to a degree that was similar to diazepam (30mg, single dose). In controlled clinical studies in over 5500 patients, 4 % of LYRICA-treated patients and 1 % of placebo-treated patients overall reported euphoria as an adverse reaction, though in some patient populations studied, this reporting rate was higher and ranged from 1 to 12%.

Dependence
In clinical studies, following abrupt or rapid discontinuation of LYRICA, some patients reported symptoms including insomnia, nausea, headache or diarrhea (see Warnings and Precautions), suggestive of physical dependence.

Apparently, the overall reporting of "euphoria" as an adverse effect was reported by 4% (range 3-12%) in post marketing trials, compared to <1% of those on placebo

[Man5onite]

Thank you so much Jatelka!
Really interesting.

*hugs*

[Adultswimmer]

SWIM has been on Lyrica for 5 years (750mg per day). SWIM has not had the potential for abuse because it just doesn't react in any good way. However, SWIM has occassionally been lazy and not gone to the pharm in time. The w/d are some of the worst ever. Irritability is not even the word. More like psychopathic and homicidal along with intense jitters, headache, nausea, etc. SWIM would definitely do a taper and not try CT with this one.

Reputation Comments on this post:

Lying gets you nowhere.

[Man5onite]

It has only been on the US-market for 3 1/2 years.

[phishHead92]

Damn Adultswimmer got CAUGHT.

Anyways

But SWIM is not addicted in the way that he needs it everyday but its more like SWIM does it so he doesnt have to deal with some of the withdraw. He only has anxiety so he takes it for that. Because of this pseudo-addiction he has switched to ativan (lorazepam) for anxiety and it has worked wonders.

The only problem with ativan is its a benzo. If SWIM repeatedly abuse it he will have the worst w/d of his life. But SWIM has a strong mind so he will stay away from fequent abuse. SWIM has tried the tactic of only abusing once a month. SWIM abused once a month for a year and then stopped cold-turkey (stopped first week of summer) and he didnt take ativan for a week and nothing, no w/d.

So SWIM is suggesting you use the "my grandma gave me (choice of drug here) and i found that it really helped" or just get another drug from your doctor. But i noticed SWIY's lower back problem? that could be tricky seeing how lyrica does do both. but its for SWIY's own good. so i suggest the switch

phishHead92 added 1 Minutes and 50 Seconds later...

oh forgot to mention SWIM has never had a opiate addiction. He has just had an amphetamine addiction. so dont hade on "worst w/d of his life"

[Adultswimmer]

Originally Posted by phishHead92

Damn Adultswimmer got CAUGHT.

Anyways

But SWIM is not addicted in the way that he needs it everyday but its more like SWIM does it so he doesnt have to deal with some of the withdraw. He only has anxiety so he takes it for that. Because of this pseudo-addiction he has switched to ativan (lorazepam) for anxiety and it has worked wonders.

The only problem with ativan is its a benzo. If SWIM repeatedly abuse it he will have the worst w/d of his life. But SWIM has a strong mind so he will stay away from fequent abuse. SWIM has tried the tactic of only abusing once a month. SWIM abused once a month for a year and then stopped cold-turkey (stopped first week of summer) and he didnt take ativan for a week and nothing, no w/d.

So SWIM is suggesting you use the "my grandma gave me (choice of drug here) and i found that it really helped" or just get another drug from your doctor. But i noticed SWIY's lower back problem? that could be tricky seeing how lyrica does do both. but its for SWIY's own good. so i suggest the switch

phishHead92 added 1 Minutes and 50 Seconds later...

oh forgot to mention SWIM has never had a opiate addiction. He has just had an amphetamine addiction. so dont hade on "worst w/d of his life"

Au contraire mon fraire! But SWIM does have a sense of humor, along with being enrolled in several clinical trials. Due to the fact that SWIM has some unusual symptoms related to SWIM's condition, and the fact that many of the routine treatments have not provided any significant improvement, SWIM has been a candidate for numerous studies including the horrific dextromethorphan one and the not so horrific Lyrica one. It also helps that SWIM lives very close to a large teaching hospital. But SWIM appreciates the laugh because SWIM has been caught at many things but that was not one of them.

Very true that benzo w/ds are some of the worst ever. NEVER a good idea to CT those unless like phishHead's friend, you can be strongly disciplined about use and are also very mentally determined as well.

But it is very common for low back (or any spine) pain to be treated with both Lyrica and benzos. Lyrica for the nerve pathways and benzos for the relaxation it induces. Tenseness increases back pain to such an extent that it can be immensely beneficial to add benzos to the regimen, and even make it possible that not nearly as many opiates are needed in some cases. In fact, SWIM knows quite a few people who are treated with all three. Chronic or intractable pain causes permanent changes in the central nervous system so it is imperative to treat pain quickly and to the highest level of relief possible. Since the last resort usually is to continue to up the dosages or move to higher levels in the Schedules of pain medication, many doctors wisely choose to add a benzo.

For that same reason, along with a few others, doctors may also add an anti-depressant. While some are prescribed off-label for various reasons and some patients may actually be depressed from the change in mobility, it is a fact and only common sense too, that if you feel a sense of well-being, the pain does not seem to be as intense.

Another option in obtaining prescriptions is to tell your doctor you belong to an online support group for your xxxxxx condition and have noticed that many others take Lyrica along with Ativan, Xanax, or Valium, etc, and you wonder if that type of treatment would work for you too. When speaking to doctors, at times it can be best to phrase your comments so that they would have to defend a negative reply. If they have to explain why it would not work for you, it can make it easier for them to say yes.

If confronted with the replies about the potential for addiction, look very serious, even slightly scared, and say something to the order of "Oh YES! I have read about that and I would never want that to happen to me. So I definitely agree that your strict instructions must be followed to the letter. Previously, I did not understand the difference between addiction and dependence. And of course, if I don't see a big improvement fairly quickly, then I would prefer to just stop taking them completely. How long will it take before I know if they are going to help me or not?" Pause for the reply then ask if a heating pad, Lidoderm patches, ice packs, a specific kind of pillow, (insert some others too) would help you in any way. Write these things down on a notepad and check the list off or make very brief notes while she/he replies to these. These are also suggestions you learned from the support group.

You just did several things. Showed that you are being proactive in your health by researching on your own, you are just as concerned as she/he is about addiction, the doc cannot use your misunderstanding of addiction and dependence against you because you do know the difference, you are attempting to find alternative methods (the list) to manage your pain, you are a member of a support group to manage feelings of fear about your changing body along with learning about what has helped others (some docs love this, some hate it), you are discussing your findings without telling the doctor what is the best treatment before you even tried it (or worse, pretending to have more expertise than the doctor), and you have most likely just turned the conversation into a positive reply by assuming the doctor surely could not be against this course of action, that would be too absurd.

SWIM has spent a considerable amount of time with doctors and hospitals, and only hopes to share some things with this support group that have worked for SWIM. Under no circumstance is any medical advice being implied.

SWIM has a tendancy to get diarrhea of the fingers late at night when SWIM's own off-label sense of well-being kicks in. SWIM is hopeful that the minor assistance might outweigh the major annoyance. Only likely if others have their own sense of well-being at the moment.

[phishHead92]

Originally Posted by Adultswimmer

Au contraire mon fraire! But SWIM does have a sense of humor, along with being enrolled in several clinical trials. Due to the fact that SWIM has some unusual symptoms related to SWIM's condition, and the fact that many of the routine treatments have not provided any significant improvement, SWIM has been a candidate for numerous studies including the horrific dextromethorphan one and the not so horrific Lyrica one. It also helps that SWIM lives very close to a large teaching hospital. But SWIM appreciates the laugh because SWIM has been caught at many things but that was not one of them.

Very true that benzo w/ds are some of the worst ever. NEVER a good idea to CT those unless like phishHead's friend, you can be strongly disciplined about use and are also very mentally determined as well.

But it is very common for low back (or any spine) pain to be treated with both Lyrica and benzos. Lyrica for the nerve pathways and benzos for the relaxation it induces. Tenseness increases back pain to such an extent that it can be immensely beneficial to add benzos to the regimen, and even make it possible that not nearly as many opiates are needed in some cases. In fact, SWIM knows quite a few people who are treated with all three. Chronic or intractable pain causes permanent changes in the central nervous system so it is imperative to treat pain quickly and to the highest level of relief possible. Since the last resort usually is to continue to up the dosages or move to higher levels in the Schedules of pain medication, many doctors wisely choose to add a benzo.

For that same reason, along with a few others, doctors may also add an anti-depressant. While some are prescribed off-label for various reasons and some patients may actually be depressed from the change in mobility, it is a fact and only common sense too, that if you feel a sense of well-being, the pain does not seem to be as intense.

Another option in obtaining prescriptions is to tell your doctor you belong to an online support group for your xxxxxx condition and have noticed that many others take Lyrica along with Ativan, Xanax, or Valium, etc, and you wonder if that type of treatment would work for you too. When speaking to doctors, at times it can be best to phrase your comments so that they would have to defend a negative reply. If they have to explain why it would not work for you, it can make it easier for them to say yes.

If confronted with the replies about the potential for addiction, look very serious, even slightly scared, and say something to the order of "Oh YES! I have read about that and I would never want that to happen to me. So I definitely agree that your strict instructions must be followed to the letter. Previously, I did not understand the difference between addiction and dependence. And of course, if I don't see a big improvement fairly quickly, then I would prefer to just stop taking them completely. How long will it take before I know if they are going to help me or not?" Pause for the reply then ask if a heating pad, Lidoderm patches, ice packs, a specific kind of pillow, (insert some others too) would help you in any way. Write these things down on a notepad and check the list off or make very brief notes while she/he replies to these. These are also suggestions you learned from the support group.

You just did several things. Showed that you are being proactive in your health by researching on your own, you are just as concerned as she/he is about addiction, the doc cannot use your misunderstanding of addiction and dependence against you because you do know the difference, you are attempting to find alternative methods (the list) to manage your pain, you are a member of a support group to manage feelings of fear about your changing body along with learning about what has helped others (some docs love this, some hate it), you are discussing your findings without telling the doctor what is the best treatment before you even tried it (or worse, pretending to have more expertise than the doctor), and you have most likely just turned the conversation into a positive reply by assuming the doctor surely could not be against this course of action, that would be too absurd.

SWIM has spent a considerable amount of time with doctors and hospitals, and only hopes to share some things with this support group that have worked for SWIM. Under no circumstance is any medical advice being implied.

SWIM has a tendancy to get diarrhea of the fingers late at night when SWIM's own off-label sense of well-being kicks in. SWIM is hopeful that the minor assistance might outweigh the major annoyance. Only likely if others have their own sense of well-being at the moment.

SWIM got switched to ativan not by doing the "grandma tactic" but because he warned his psychiatrist about his possible addiction to lyrica and therefore got switched to ativan, SWIM didnt care what he got just anything where he doesnt have a slight addiction to. He has tried the "grandma tactic only twice and it has worked, once to get off of adderall and on focalin for his ADHD, and then once to his doctor not psychiatrist for getting a bottle of vicodin for his recent wrist problem.

so SWIM was just giving an idea, not an order, they can take it or leave it so chill.

Reputation Comments on this post:

Please quote selectively, rather than the whole post