Lyrica a Better Choice Than Opioids for Harnessing Fibromyalgia Pain and its Consequences

Lyrica a Better Choice Than Opioids for Harnessing Fibromyalgia Pain and its Consequences

Lyrica (pregabalin), when used on its own for fibromyalgia, is superior to opioids in reducing pain and improving pain interference in daily life, finds a study sponsored by Pfizer.

The analysis, which included 1,421 fibromyalgia patients, showed that those using Lyrica doses recommended for fibromyalgia treatment had the best outcomes, suggesting that many patients should increase their doses to reach recommended levels.

Pfizer and ProCare Systems conducted the study, Interpreting the Effectiveness of Opioids and Pregabalin for Pain Severity, Pain Interference, and Fatigue in Fibromyalgia Patients,” which took aim at the notion that — despite little evidence of their effectivity — opioids are the most commonly prescribed drugs for fibromyalgia. To examine how different treatments affect pain and related outcomes in fibromyalgia patients, the research team turned to information from the ProCare Systems network of chronic pain clinics in Michigan.

All patients received Lyrica or opioids alone or in combination, and had been through several pain health assessments, including pain characteristics, physical function and psychosocial function.

The team divided the patients into different groups based on their average morphine equivalent dose or average Lyrica dose. Patients were followed between 56 and 365 days. Nearly 78 percent of them were women — typical of fibromyalgia in the real world.

Findings, published in the journal Pain Practice, showed that only 3.4 percent of patients took the recommended Lyrica dose of 300-450 mg. Most patients took less than 150 mg of Lyrica, either alone or combined with high-dose opioids.

The team assessed the number of patients in the different medication groups and noted that more of those who took Lyrica without opioids achieved at least 30 percent improvement across all pain measurements.

Lyrica treatment was also superior to opioids or opioid-Lyrica combinations in improving pain-related aspects, such as “ability to enjoy life, activity in general, mood and sleep.” The only pain-related aspect that was better in the group combining Lyrica and moderate doses of opioids was “relationships with others.”

When increasing the threshold to an at least 50 percent improvement in pain and pain-related aspects of daily living, Lyrica was again superior to opioids or combinations.

While Lyrica did score low on how well it affected fatigue, it did better when combined with moderate opioid doses.

“Pregabalin without opioids provided the most favorable outcomes overall based on ≥30% and ≥50% improvement thresholds … with support for moderate … opioids+pregabalin in patients suffering from fatigue” researchers wrote.

Researchers also noted that patients taking higher Lyrica doses, reaching the recommended dose range, had better outcomes than those taking low doses.

41 comments

  1. StevefromMA says:

    Wow, Lyrica sounds like a miracle drug for fibromyalgia!! Wait, who makes Lyrica? Who ran the study LOL?

    No one stays on Lyrica, got me so disoriented I didn’t know I was in my driveway. Also, didn’t touch pain.

    We need better research and new meds, not trying to prove old meds work, like all of the manufacturers keep doing…change dose, coat differently, repackage..all baloney.

    • Nuschler says:

      100% agree.

      Wow! Pfizer makes Lyrica and finds it to be a MIRACLE drug for FMS!!

      If you watch or read an ad for Lyrica it mentions as a side effect of “possible suicidal action.” (NOT ideation…but ACTION.) I was the person who filled out a 17 page “Adverse Drug Reaction” form.

      10 years ago I took Lyrica for 5 days–75 mg/day. First time this army doctor had prescribed it. (I was an army spouse.) On day 6 I got my few sleeping pills and pain pills together. Got a thin plastic dry cleaner’s bag, and duct tape. When my spouse went to work, I started to carry out my plan. I was going to take the pills to make me sleepy, then put the bag over my head and use duct tape around my neck so I would suffocate.

      I stopped and thought “What am I doing?” I’m a nurse practitioner so I went back to the ORIGINAL clinical research. 2% of clients had ALSO noted suicidal ACTION. Not just thinking about suicide but actually making a plan and trying to carry it out. Pfizer simply dropped those people from the study and NEVER MENTIONED IT.

      Only after submitting the report did Pfizer finally add it as a warning.

      Pfizer is SCUM.

      • I believe that may have been a result of a combination of drugs and their interaction. Depression is also a side effect of fibromyalgia. I’m sorry you were effected in this way. Everyone is effected differently. I was recently prescribed a prescription with my diagnosis of early stage Alzheimer When I read the side effects, I declined it. They were worse than my current condition.

    • FibroWarrior says:

      I totally agree with you, Steve! Why did they even post this article? I thought this was a trusted site, but this is the second article that I have an issue with, and the facts are just not true!

  2. Gary Bryer says:

    I am sorry to disagree, but nerve pain, although an issue, fibro tends to be mostly muscle pain. Lyrica is meant for diabetic nerve pain. Lyrica helps about 30%; does nothing for muscle pain, and is pretty much not effective against FMS.

    • Dot says:

      I think the type of pain in fibro pain differs greatly from patient to patient, mine IS more nerve pain than muscle pain, however I have read of lyrica causing side effects of eye rolling and face pulling , so this puts me off changing from amytriptaline

  3. Leigh says:

    Pfizer, the maker of Lyrica “sponsored” -paid for – the study! Please be advised that Lyrica is ADDICTIVE (horrendous withdrawal symptoms) and has a litany of deplorable side effects. Many are now using Lyrica recreationally. If you find Lyrica works for you, good for you. However, be educated about it and be very, very cautious!Many can not tolerate the drug but tolerate and need opiates and/or many take and need Lyrica and opiates.
    Total hypocrisy regarding Lyrica that negatively affect individuals who require opiates.

  4. Stephen Strong says:

    Lyrica did NOT work for me. It gave me next-to-nothing in terms of pain relief, and caused me to rapidly gain weight in an astonishingly short time: ten pounds in two weeks!

    I am a man with fibromyalgia, first diagnosed over fifteen yeard ago. The most effective drugs for pain relief,for me, have been opioids, namely Oxycontin and oxycodone. This push to take everyone off opioids will only end up causing more suffering for those of us who do not respond to the latest overpriced mouse milk from Big Pharma, and increased profits for drug companies as their brand-name opioids come off patent.

  5. Sam says:

    Oh please, how can a tablet that’s made me gain 2 stone within 1 month whilst sticking to a diet be beneficial to anyone. Get back into your labs and create something without the extreme side effects! Oh and little did I know that everyone who takes this medication ends up looking like a balloon either thanks Pfizer! #lyricaweightgain

  6. Mandy says:

    I think some of these “wonderdrugs” pushed by the big pharmaceutical companies are doing more harm than good, and most of the side effects are actually worse than the condition itself! Since I was officially diagnosed 4 years ago, I have tried several different types of medications (gabapentin, amatryptoline, Cymbalta) and each one had side effects that really had a negative impact on my life. My pain specialist suggested we try one more just to help with my ongoing migraines, and pair it with the alternative therapies that I was already doing and see how that worked. Today, I take Topiramate and exercise regularly, and see a massage therapist and chiropractor once a week. I also take CBD oil when needed which also helps with inflammation. I also take vitamin supplements and eat healthy and all of this has made a huge difference in my life. I still have pain and occasional flares, but I have more energy and less brain fog than I used to. I use over-the-counter muscle relaxants or other pain relievers if needed, but usually only at night. I may not sleep through the night, but I’m also not pumping my body with lots of unnecessary drugs either!

    • Gary Bryer says:

      Pfizer can say what they want, Lyrica, has NOT, and does NOT work for the vast majority of people with fibromyalgia. The fact someone ALSO has nerve pain, which Lyrica does help (presumably), DOESNT MEAN THAT IT HELPS WITH MUSCULAR PAIN! Phizer can pay to get the results they want from a study, but that doesn’t change the facts.

  7. Jo says:

    I refuse to take this drug based on the horrific side effects, the fact that the effects are short term and you have to keep upping the dose and become addicted and the withdrawal is sometimes worse than being on it. I’ve known people on it that have said it has help for a bit but had to up the dose dramatically then got serotonin syndrome which can be fatal if you don’t know what to look out for

  8. Wendy P. says:

    I wholeheartedly agree with all of the comments here. Here are some articles that refute this latest self-serving study by Pfizer. https://fedupwithfatigue.com/why-your-fibro-meds-arent-working/ This article analyzes Pfizer’s previous studies, and asserts that Lyrica is not much more effective than a sugar pill. http://nationalpainreport.com/marijuana-rated-most-effective-for-treating-fibromyalgia-8823638.html In a poll conducted by the National Pain Foundation, 61% of the respondents stated that Lyrica did not work at all for them, 29% stated Lyrica helped a little, and only 10% stated that Lyrica was very effective. http://nationalpainreport.com/are-opiates-really-that-bad-for-fibromyalgia-8829589.html This article states that the recommendations against opiate use for fibromyalgia are based on data from less than 100 subjects. Let’s get real Pfizer!!! I believe the current “opiate epidemic” is reminicent of the “reefer madness” hysteria. IMO, there is a chronic pain epidemic and it is the chronic pain patients that have become collateral damage in the wake of greed, corruption, and self-serving propaganda. Due to the current circumstances, I take Kratom.

  9. Shy says:

    I agree, both Lyrica and Cymbalta are great replacements; however, having used both and being a research guinea pig for Lyrica I can say for some patients these may have significant side effects. Initially, I was so excited because they took away the pain. It was a miracle. Unfortunately that was short lived due to migraines, increasing weight gain, irritability, etc. etc. etc.

    My hope is that you try these and that they work well long term.

    • Shy says:

      Addendum: I use blue label CBD gel under the tongue. It has no side effects for me. No high either. My son uses the CBD salve which helps repair cartilage, and he also vaps the CBD, which he says works better for him. I have a friend that uses Kratom and says it works great for her. I have not tried it.

  10. Carl Weggel says:

    I acknowledge that I appear to be the QUITE RARE exception: I have been taking Lyrica ever since I participated in a clinical research study for Lyrica in 2009 (by Boston Clinical Trials, for a 330mg, once-a-day, Controlled-Release version of Lyrica). For me, Lyrica IS the “Miracle Drug” for fibromyalgia. It reduces my pain from barely tolerable to barely noticeable. Astoundingly, I have NO adverse side effects whatsoever: Unlike opioids, Lyrica is non-addictive. If I miss a dosage or two, the fibromyalgia returns with a vengeance–but otherwise, I suffer no withdrawal symptoms whatsoever. Over the nine years, my dosage has increased from 300mg per day to 400mg per day, as my fibromyalgia grows inexorably worse. Lyrica alleviates “fibro-fog,” but does not alleviate fatigue. One last virtue: Lyrica is effective–or ineffective–within one day, or less. It is worth a try for one day, or so: three or four, 100mg pills. Note: Lyrica is QUITE expensive, but a generic version may become available in 2019. I hope that you will be as lucky as I was.

  11. Kay says:

    Let me start by saying I’m not a doctor…however, I do have a background in organic chemistry and I find these types of studies frustrating. It’s natural for a pharmaceutical company to publish articles on the validity of their own products. It’s the companie’s responsibility to demonstrate safety and efficacy, as well as long term follow up studies on patients from multiple demographics, including pain level and combination therapy. However, this kind of wording can imply that Lyrica is a “magic bullet” to those without medical or scientific training. Conflicting studies show this has not been proven in the general patient population. I would like to see more peer reviewed articles posted here, in which academic/research groups “compare notes” and examine the claims found in publications similar to those above. I personally have not found relief in any of the drugs used to treat neuropathic pain. I find little relief and suffer more from the side effects than the fibromyalgia. These drugs are being pushed on patients to prevent opioid addiction (with varied evidence to support addiction in chronic pain patients) yet are addictive themselves. I would much rather treat my flare ups with a high clearance opioid (for me as needed and with zero side effects). I’m lucky in that I still have the ability to exercise and manage my pain with heat and massage. I’m afraid that many fibromyalgia patients will lose their opioid medication and the pain relief and independence it gives them due to politics.

  12. Michelle says:

    The symptoms of my Fibro consist of neuropathy and severe full body muscle pain, with one area of muscles always hurting and spawning worse than the others. I have been on Lyrica since 2012. It does help my neuropathy but it doesn’t help the bodywide muscle pain at all.
    Isn’t it a bit suspicious that the maker of Lyrica did this study? I am afraid the results won’t bode well for us Fibro sufferers.

    • Carl Weggel says:

      Dear Kay,
      I am a member of a Fibromyalgia Support Group in nearby Reading, MA. Even in this suburban area of Boston, the Study Group has 252 members!!! Fibromyalgia can be utterly debilitating: Most of the members are desperate–many suffer so from severe fatigue and/or “fibro-fog” that they are rarely able to roust themselves from bed to attend the meetings. All of those (who attend the meetings) and who have tried Lyrica report such unpleasant side effects that they immediately discontinue usage. For reasons unknown to me, the Group reports their best results with Low-Dose Naltrexone (LDN), a dosage of ~5 mg.
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3962576/
      I hope that others will concur: Naltrexone is extremely low cost, minimal side-effects, readily available, and non-addictive. Sooner or later, I, too, will give it a try.

    • Carl Weggel says:

      Dear Michelle,
      As I reported in my previous Comment today, the local Support Group in nearby Reading, MA–with 252 members–reports their best results with Low-Dose Naltrexone–a dosage of ~5mg (once a day, I assume?). With a free coupon from GoodRx.com, at Stop & Shop, 30 50mg tablets cost $31.75. If you break the tablets into tenths, each tenth cost a mere dime! Ask your doctor: with his approval, LDN may well be worth a try!
      Carl Weggel

  13. LK says:

    Buhahaha! When the company funding the research *makes* the drug, and profits from the drug they are researching, all credibility is lost.

    What a crock of @#$%&!

    Lyrica helps less than a third of patients with fibro. Opiods are way more helpful, but get ready for those drugs to be even harder to get, now that we’re all drug-seeking addicts.

  14. Nancy says:

    All Lyrica did for me was make me loopy. It did not decrease my pain levels, indeed it did not touch them at all. Not wanting to be loopy all the time, I stopped taking it with my doctor’s approval.

    • Anita says:

      I agree! Lyrica made me feel stupid and slow, and did nothing for the pain. I found it nearly impossible to do my job as a college professor, and failed an important certification exam. I also gained 20lbs. Once I stopped it, I felt normal again, passed my exam, and lost the weight. Lyrica is awful!

  15. Gary Bryer says:

    Lyrics for fibromyalgia is bullshit! Approx 30 percent of people w/fibromyalgia feel some relief, and that because they also nerve pain. The drug is supposedly made for diabetic neuropathy. There was one good side effect from the Lyrica/fibromyalgia ad campaign. After so many years being considered a fake, nuts, lazy, or hearing that there no such thing as fibromyalgia; and it was all in my head. Even my doctors told me that there was no such thing as fibromyalgia , it was all in my head. Part of me has to wonder, if this attitude is because 80 percent of those afflicted r woman. I am a man who was lucky to contract fibromyalgia, so was my wife, my 19 y/o son, my 34 y/o step son. At any rate, the Lyrica commercials actually validated fibromyalgia. Most people now believe fibromyalgia is legit. Esp since I don’t look sick. That, to me, and others was a major event. Consider not only the body pain, but how about all of the accompanying little presents that fibromyalgia gives us. Like IBS, back issues, mental issues… it is a huge deal, knowing it’s not in my head. People believed that (including doctors) that a diagnosis of fibromyalgia was for lazy people. There was nothing wrong with us. Sorry, I know this kinda off topic, but it all happened.
    Thank u,
    Gary Bryer
    tbptoo@yahoo.com

  16. Absolutely not! I pray people realize this medication is awful for fibromyalgia. Please change the title to make sure people know the study is biased because it is. I urge anyone to try other ways to relieving their pain until we understand this condition more than we do today.

  17. Dede says:

    Lyrica was absolutely horrible for me. Made my legs swell up with water. Did not touch the pain. Was on it for a couple of months before coming off. The withdrawl was a nightmare. Never trust a study done by the maker of the drug. All they want to do is sell prescriptions.

  18. Dede says:

    I am now coming off of Cymbalta, which I was on for a year. It left me extremely fatigued. I am a highly productive person and mom to many children. Cannot spend my days sleeping. The only thing that does work is a combination of high dose ibuprofen and opioids. The other “miracle” drugs are a pharmaceutical sham. I have tried medical marijuana and it works well, but it isn’t a lifestyle choice I can live with.

  19. Bonnie says:

    Wow,kind of funny when I had my daughter they gave me perocet,and most of my pain was gone.When I took Lyrica it didn’t even touch my pain!In fact I might as well popped a sugar pill.

  20. James milne says:

    yep my body has also ballooned out of control with the use of Pregablin, my hands are so swollen I can’t even squeeze toothpaste out of its tube, I maybe have rheumatoid arthritis as well, F/M is a working progress with many countries trying to find an affordable cure or at least something to ease the pain. but who is doing the research without bias.

  21. Diane says:

    Yeah, pffft. I’m going to put a lot of weight in a big pharma drug study of their own product. Right. No bias there. What a crock. I’ll grow my own med. marijuana and do the raw juicing of the leaves. I have more faith in natural choices than big pharma, speaking from years of horrible allergic reactions to their poisons.

  22. Terri says:

    A study sponsored by the drug company who makes the drug??? You have got to be kidding me. You can’t take any of the results from this study seriously. I gained 15 lbs in less than 2 weeks, and it was all fluid. I couldn’t even put my shoes on. The doctor took me off of the Lyrica immediately after I saw him with this condition and red-flagged the drug in my file. After reading the horror stories from people who have been on it I am surprised this poison is still being promoted.

  23. Megan says:

    I cannot stand those commercials for Lyrica! “My doctor says moving more helps Fibromyalgia pain, and Lyrica can help!” Seriously? First of all, Moving more causes me more pain, not less! I am taking or have taken the lidocaine patches, Tramadol, Gabapentin, Savella, Lyrica, Cymbalta and it some only caused me to feel loopy, and did anything to relieve my pain! The only pain relief I do get is from my 12 hour painkiller and my oxycodone and half the time it just barely takes the edge off. I have Just ordered CBD oil, I have heard amazing things about it but I won’t know until I get it if it will work, I pray it works because I would love nothing more then to get off all these pills!

  24. Bonnie says:

    I had a combo of Cymbalta and Lyrica as last RX. I quit Cymbalta on my own after 3 years, still on 450mg Lyrica and today my legs hurt like he… Also, I too gained 20 pounds within 2 months (no diet change and I’d worked to keep my weight at a certain number). Bu the weight gain was not early on, just after I’d say 2 yrs (?) on ramping up the dosage. And still, the pain is not letssened.
    Hugs to all. I get little to no understanding or compassion from in’laws, step daughter, even my husband. So here comes the holidays, travel and so. For me it makes my pain worse because I don’t want to be there, for the rest of you I pray the love of family and all will take you away from the pain.
    `

  25. Fadhil Zwer says:

    Not every study done mean the results are applicable many studies after a time prove to be wrong or unpractical so I advice to wait for more studies about laryca for fibromyalgia if prove valid then I may use it for my patients.

  26. Roy Nielsen says:

    I had a horrible experience with Lyrica. One unpleasant side affect was significant weight gain. Another was that it made the ‘fibro-fog’ worse. Another was that I was so tired all the time, it was difficult for me to perform at work at all. I would not have been able to be a productive contributor to society if I had remained on Lyrica. One must consider the source of the study. A study that is performed by a financially involved party in a product should not necessarily be put forth as fact. Had this been an independent study, by people who had no financial investment in the product, the results would have much more weight.

  27. I am 78 years old. I have had fibro for over 40 years, even before it was given a name. Lyrica has been a life saver. I started many years ago with a trial program. It has lost it’s effectiveness, but I continue with it because a new effective medication has not been discovered. I now have an additional condition, beginning stage Alzheimer. I wonder if this is an extension of “Fibro Fog”, This new diagnosis scares the H— out of me. Has there been any discussion on this aspect? I found some discussion in foreign countries such as China, but nothing here in USA.

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