Lyrica Withdrawal

[pally pete]

Now I've been through all 3 I think I'd still say the Lyrica WD was the worst. It can combine some of both if you really abuse them. Even though I've been through benzo WD several times since before Christmas, and the last time I had to go to a hospital when I ran out of benzos on Easter Eve and couldn't get any more. I was a mess, and the doctor prescribed me 25 Sobrils after trying to get me to check myself in somewhere. I was really ill, talking to the shadow people, and feeling close to death the whole time.

But it was no worse than Lyrica where I think I was even closer to death. I just didn't know what to look for, but I was very close to a seizure or heart-attack, and the brain-zaps would knock me out all the time. But definitely not "nothing" compared to benzos and opiates - if I had to choose I would choose opiates first, then benzos, then Lyrica.

You don't need to feel like you're quitting both at once and no others take 10 full days before they allow you to feel better, in my experience. Normally I'm over the worst in 3 days, but Lyrica didn't let me feel better before 10 days, but then it was like I was well again suddenly over night.

Just out of interest how bad was your habit when you quit Benzos?

As you mention being over the worst in 3 Days, I've gone through withdrawal many times and I have certainly not been over the worst in 3 days. It was usually closer to 3 weeks or more before the physical symptoms gradually began to subside.

 

[pasha]

All or most of the reports of this “withdrawal” were from people looking to replace or withdraw off of gaba agonist.

Some were also abusers of opiates. Most if not all were stopping the other drug intake.

It looks like people are damn near forgetting that they have other addictions.

Lyrica still has till this day has caused me no WD upon years of on and off usage within 1-5 thousand milligrams...

What most are saying doesn’t make any sense.

While I do concede that in *some* reported cases there seems to be an indication of a causal relationship between gabaergic abuse and gabapentin/pregabalin withdrawal, poly-drug use however, can be a factor in any withdrawal. So what you just said regarding people "forgetting they have addictions" can be applied to any other withdrawal - couldn't it? Why should pregabalin be any different? One can almost always however, identify the root cause in withdrawal during poly-drug use. With pregabalin withdrawal this can be done IME, since it's very different to traditional benzodiazepine withdrawal. Again, subjectively speaking, the gap in difference is larger than that of GHB and benzodiazepine withdrawal.

Anti-convulsant withdrawal isn't a rarity, and some people experience absolutely horrendous withdrawals from lamotrigine, carbamazepine, and several others.

Just because it didn't happen to you, it doesn't mean it can't happen to others. There seems to be far too much corroborating information for this to be a fluke or for one to be able to prematurely underline a single mechanism behind these withdrawals (eg. co-morbid gabaergic addiction).

Related reading:
Gabapentin: withdrawals? mechanism of action? benzo cross-tolerance/dependence?

 

[Ninae]

It's not really that Lyrica WD is worse than benzo WD, in itself, or, after having been through benzo WD, I think that part of it is pretty much the same, but, as opposed to benzos, it also has a lot of the deep depression and sickness of an opiate WD.

So I think the way it combines symptomps from both withdrawals makes it really bad. If you've been through benzo withdrawal, you know you have about as much as you can manage, anyway. You might not be as deeply depressed, but you're still in a shitty mood, which has more irritability and anxiety, or is more like being kept in a "fight or flight" state for a long period of time. You don't really get the kind oif depression you would have from ending painkillers. And this is a good thing as the withdrawal symptomps from benzos alone are enough.

Really, having seen how Lyrica works, I would say it has properties of benzos, painkillers, AND stimulants. There's definitely some kind of "upper" action going on that allows you to be in activity (if desired) on such a strong downer. But at the same time you're just as happy to be doing nothing. So I really think it must have been developed specifically for satisfying cravings, with the way it can be used as a substitute for all the main drugs someone are likely to be craving. Of course that period is over now, but I can see it first being given to those who had a good reason to ask for it (i.e. those who are looking after difficult inmates or children), as it can allow you both to relax and be active, and seem quite normal from the outside.

But from the inside you're completely intoxicated, has to be the most euphoric pills I've ever tried (apart from strong opiates, that are stronger, but different), and of course they found out it was too much of a drug. So now I think doctors view it on the same level as benzos, etc. (though I wonder if they know how effective of a recreational drug it really is?).

Much better than benzos, in my opinion, which has never given me any euphoria. Though I discovered that doesn't need to mean you're not hurting without them. But stopping Lyrica is a bit like stopping some serious multi-drug use all at the same time. I think the deep depression can only be a sign of stopping painkillers/stimulants suddenly as benzos don't make you feel that kind of despair. You're freaking out and feel like you're going to die, but you're not as low (I had been using very high doses of Etizolam, I won't even mention how much, but it involved me blacking out and eating as many pills as I could for a couple of days).

 

[Psychedelic Jay]

Literature specifically states even right in the info from the pharmacy:

1. Lyrica is to go along with another anti-convulsant if one is already being used.

2. Can be used alone as an anti convulsant.

3. It will make epilepsy worse upon withdrawal in known epileptics...
1.This includes people withdrawing from other Gaba agonist or calcium channel blockers.

4. Dosing super high leads to a rebound in suppressed catecholamine release leading to elevation back to normal levels upon withdrawal.
1. there is little to no long term malaise upon withdrawal even in abuse.


These are the points I’m making.

The people who seem to be affected are people on other anticonvulsants, as well as severe abusers of this drug...

The only people in any life endangerment remotely close to benzo/barb withdrawal, are the people already on them... as well as epileptics.

So as far as I’m concerned, there is severely over the top exaggeration going on here if they are only doing lyrica, or only coming off of the lyrica while on another drug...

 

[Ninae]

I wasn't taking any other Gaba-agonists. Anyway, no one are saying it's objectively the worst WD in the world, but that we personally experienced it that way. And from what I've seen I'm not alone.

 

[Psychedelic Jay]

I understand.

I know there is a withdrawal, but it is more of a "return to normal”

It does suck having that same old anxiety that you once had come back... That, I know.

But, nothing has ever gotten worse.

 

[pasha]

Literature specifically states even right in the info from the pharmacy:

1. Lyrica is to go along with another anti-convulsant if one is already being used.

2. Can be used alone as an anti convulsant.

3. It will make epilepsy worse upon withdrawal in known epileptics...
1.This includes people withdrawing from other Gaba agonist or calcium channel blockers.

4. Dosing super high leads to a rebound in suppressed catecholamine release leading to elevation back to normal levels upon withdrawal.
1. there is little to no long term malaise upon withdrawal even in abuse.


These are the points I’m making.

The people who seem to be affected are people on other anticonvulsants, as well as severe abusers of this drug...

The only people in any life endangerment remotely close to benzo/barb withdrawal, are the people already on them... as well as epileptics.

Points 1-3 are irrelevant to the discussion. Point 4, and "I know there is a withdrawal, but it is more of a 'return to normal'" are classical of any withdrawal. You don't know "everyone".

So as far as I’m concerned, there is severely over the top exaggeration going on here if they are only doing lyrica, or only coming off of the lyrica while on another drug...

Your opinion, self-reports and case reports provided in that thread state otherwise. I've been a pregabalin user pretty much since its birth, and it's certainly not an exaggeration by any means. Having gone through GHB, benzodiazepine, and opioid withdrawal, I can easily say that pregabalin is the most unpleasant. Perhaps not the most life threatening, but certainly the most discomforting. I don't see what people gain from exaggerating, and moreover, it iirks me when people refuse to acknowledge the facts presented in case reports.

 

[Psychedelic Jay]

Since when did contributing factors become irrelevant?

 

[pasha]

You state that pregabalin should be used concomitantly with another anti-convulsant when one is already present or it can be used as a stand-alone drug if no other anti-convulsant(s) are present, and that pregabalin withdrawal can worsen the symptoms of epilepsy in epileptics upon withdrawal.

Maybe I'm missing something, but I fail to see how these are contributing factors in pregabalin withdrawal, especially points 1 and 2. Perhaps you didn't elaborate enough.

 

[Psychedelic Jay]

Those are the only ways pregabalin is remotely that uncomfortable and/or dangerous if it even is uncomfortable....

Unless you are allergic to it, you have to be using it grossly incorrect for any remote danger (failure of the kidneys)

I highly doubt anyone on this thread strictly uses lyrica or uses it correctly...

Returning to normal should in no way be labeled as withdrawal...

 

[pasha]

Too many subjective statements, generalizations, and assumptions. I'm done being the minister of defense for those who refuse to face facts. I'll continue warning people that this drug carries a risk of dependence, addiction, and withdrawal. Others can continue to do the opposite.

Returning to normal, or achieving homeostasis, is exactly what happens when one is in withdrawal.

 

[Psychedelic Jay]

No shit...

It is the return of the anxiety you already had... Nothing greater or worse.


Five people do not make something a fact.

I’m done now... LMAO

 

[pasha]

Clinical studies, and case reports, are facts. There are about 8 in the thread linked, and I will link you to more if you wish. The thread posted by Toz at the beginning of the linked thread, has thousands of anecdotes. I'm not sure what you're referring to when you say "5 people".

When you say it's "returning to normal", that implies homeostasis. Chemicals readjusting to return to a "normal" state. This is the case with opioid, gabaergic, and every kind of withdrawal, including pregabalin. Your posts are vague, contradictory, and you're failing to comprehend what's being said to you, and the points you're conveying. Instead choosing to grasp on to your stubborn opinion. I never mentioned anything regarding anxiety in our discussion.

You fail to answer major questions I've made throughout our discussion. Then you conclude with a LMAO - typical of an individual falling considerably short in making a counter-statement. As a user of this drug, I would see why you would be a cynical, but to laugh at others suffering, is somewhat below par of any individual. Show a little more respect, even if others don't fit into your set criteria of what withdrawal should and shouldn't be, even though you haven't lived through it.

 

[Psychedelic Jay]

Clinical studies, and case reports, are facts. There are about 8 in the thread linked, and I will link you to more if you wish. The thread posted by Toz at the beginning of the linked thread, has thousands of anecdotes. I'm not sure what you're referring to when you say "5 people".

When you say it's "returning to normal", that implies homeostasis. Chemicals readjusting to return to a "normal" state. This is the case with opioid, gabaergic, and every kind of withdrawal, including pregabalin. Your posts are vague, contradictory, and you're failing to comprehend what's being said to you, and the points you're conveying. Instead choosing to grasp on to your stubborn opinion. I never mentioned anything regarding anxiety in our discussion.

You fail to answer major questions I've made throughout our discussion. Then you conclude with a LMAO - typical of an individual falling considerably short in making a counter-statement. As a user of this drug, I would see why you would be a cynical, but to laugh at others suffering, is somewhat below par of any individual. Show a little more respect, even if others don't fit into your set criteria of what withdrawal should and shouldn't be, especially that you haven't lived through it.

How dare you... I’m laughing at me continuing on such a pointless endeavor... Those studies show general malaise at best... Which was there before.


Very little discomfort is not full blown withdrawal. Only poly drug users seem to notice full blown effects, after they stopped the other meds...

I see nothing that says quitting lyrica is even remotely painful besides threads... Which should be taken with a grain of salt...

 

[pasha]

Quotes from some of the studies, since you can't be bothered to read properly:

Patient with only a past history of psychiatric illness, clearly presents physiological symptoms:

The patient displayed moderate upper respiratory tract infection symptoms and somatic complaints 1 day after termination of gabapentin. These symptoms gradually worsened until 10 days after, at which time she acutely developed severe mental status changes, severe somatic chest pain, and hypertension. Physical examination, electrolytes, electrocardiogram, computerized tomography, magnetic resonance imaging, and magnetic resonance angiography were all normal. Upon reintroduction of gabapentin, the patient returned to baseline within 1-2 days.

reports have suggested that some withdrawal symptoms can present after 1-2 days upon abrupt discontinuation of gabapentin after chronic use within young to middle-aged patients. These symptoms mimic that of alcohol and benzodiazepine withdrawal purportedly due to a similar mechanism of action. Unique to this case is that this geriatric patient developed debilitating withdrawal symptoms after a gradual, week-long taper of gabapentin along with flu-like symptoms. It is proposed herein that a gabapentin taper should follow a course similar to that of a benzodiazepine taper -- slowly and over a period of weeks to months.

Source:http://www.ncbi.nlm.nih.gov/pubmed/15898970

Patient with history of ethanol abuse, only returns to normal state after gabapentin is reinstated:

A patient developed apparent withdrawal symptoms beginning two days after gabapentin therapy was discontinued. The symptoms were unresponsive to treatment with benzodiazepines but completely resolved with the reinitiation of gabapentin therapy.

Source:http://www.ncbi.nlm.nih.gov/pubmed/20484214

One early case report described a 48-year-old female with a 20-year history of bipolar disorder (J. Clin. Psychopharmacol. 1999;19:188–9). She was treated with gabapentin 500 mg/day for approximately 4 weeks for hypomania, at which point she became depressed. (Other primary mood stabilizers caused side effects.) The gabapentin was tapered off, and within 48 hours of the last dose she became catatonic. After several days, she was successfully treated with lorazepam. The authors considered withdrawal from gabapentin to be the cause of the catatonia because the patient had never before experienced such a state.

Another investigator described three case reports of gabapentin withdrawal (Clin. Neuropharmacol. 2001;24:245–6). The first case was that of a 29-year-old male treated with gabapentin 4,800 mg/day over 6 weeks for bipolar disorder. (Other mood stabilizers were intolerable.) He ran out of tablets and had no access to a refill. Within 1 day of the last dose, he experienced anxiety, diaphoresis, and palpitations. By day 3, he was confused and his spouse brought him to the emergency department. He was tachycardic, tachypneic, and hypertensive. Physical exam, blood counts, chemistry panel, urinalysis, urine drug screen, and head CT were all normal or negative. Gabapentin was reinitiated, and the patient began showing recovery within hours.

The second case was that of a 36-year-old male treated with gabapentin 3,600 mg/day over 2 months for bipolar disorder and chronic back pain. For financial reasons, he abruptly discontinued gabapentin. He presented in a very similar fashion to the first case; the work-up was negative except for asterixis, myoclonus, and the presence of agitation. Gabapentin was initiated again, along with a single dose of lorazepam (2 mg IM). He began recovery within hours.

The third patient, a 28-year-old male treated with gabapentin 2,400 mg/day over 6 months for migraine headaches, left town without his tablets. Within 48 hours, he presented with irritability, diaphoresis, and a headache. Physical examination was normal. Symptoms resolved upon reinitiation of gabapentin.

A separate case report described a 34-year-old male with lumbar disk disease who was treated with gabapentin 8,000 mg/day for 9 months (J. Toxicol. Clin. Toxicol. 2002; 40:925–. He ran out of tablets and was unable to obtain a refill. After 2 days, he presented to the emergency department in status epilepticus. He had no prior history of seizure disorder and was not receiving other medications. Medical evaluation for other causes of seizure was ruled out. He was restarted on gabapentin (at a lower dose) and did well.

Other investigators described two cases of gabapentin withdrawal (J. Clin. Psychiatry 2007;68:483–4). The first patient was a 33-year-old man with a history of alcohol dependence and alcohol withdrawal delirium tremens. Multiple reliable sources indicated that he was using only cannabis, and laboratory studies were consistent with collateral sources. He received gabapentin 3,600 mg/day for alcohol cravings; 3 days after running out of tablets, he presented with confusion, diaphoresis, disorientation, agitation, tachycardia, hyperreflexia, and tremulousness. He was treated with lorazepam 6 mg/day and haloperidol 10 mg/day for 1 day without benefit. Gabapentin was restarted at 1,800 mg/day with resolution of his difficulties.

In the second case, a 63-year-old male was prescribed gabapentin 1,800 mg/day for chronic back pain. (He was actually taking more.) For various reasons, gabapentin was abruptly discontinued; 3 days later, he was hallucinating, tachycardic, febrile, diaphoretic, tremulous, and agitated. Over the next 2 days, he received 48 mg of lorazepam with limited improvement. On day 6, gabapentin 1,200 mg/day was restarted with rapid recovery.

The Conclusion

The database for gabapentin withdrawal is in the early phase of development and is entirely based on case reports, but cases of gabapentin withdrawal have included catatonia, seizure, and delirium tremens-like withdrawals, which is consistent with the presumed mechanism of action.

Source:http://psych.imng.com/fileadmin/cont...70473_main.pdf

Malaise?

 

[Psychedelic Jay]

Predisposed people... Far from normal... Gross doses... Sounds like stuff that could have been avoided regardless of argument. That only happens to a small percentage of people.

Where are the majority rules? Threads and individual case reports still contribute nothing but a super small population... All drugs effect at least a small percentage of people adversely...

It still doesn’t conclude that it is addictive...

It seems they are snapping into it... Much like doing too much LSD or PCP and never coming back...

Good call. So now my argument goes on a tangent. I shall open a new thread.


What are the predispositions that these individuals have in common?

 

[Ninae]

You're assuming a bit much when you keep saying "anxiety and general malaise was there before".

I wasn't talking about the return of your old self that comes back when you stop taking pills and don't think that really qualifies as "withdrawal". I'm talking about spending many days in an alarm state where your body is very sick and your mind is very freaked out. I didn't start taking it because I had anxiety but I was quite anxious THEN. Just like when you stop taking benzos, it can make you 5 times as anxious as normal. I think the same happened here except there was a depression that was just as strong. And I'm talking about the kind of depression that is caused by chemicals, that comes for a few days, then leaves for no other reason.

Either way, I've had at least a handful write to me just to say they went though the same thing, so it seems like it's rather common and the fact that some don't doesn't really make much difference. We also don't know the full context all of them took it in, with what other drugs, etc. So I think beginners should keep that in mind as an opportunity. I can't remember anything else that has made me sick for 10 days and an epilepsy medication, which it's being sold as, is quite serious to get addicted to.

 

[Psychedelic Jay]

Ok... Here is the thing...

There is just not enough solidness to this whole thing...

If it were as bad as most claim, some media would have hopped all over it in an attempt to gain good publicity.

This still remains a gray area. and for all I know, we are all wrong. Something is predisposing you and others...

 

[pasha]

Where are the majority rules?

Relatively new drugs. Initial case reports usually are the seed, and more will definitely continue to emerge. It's already mentioned in many packet inserts (the one from pfizer for me) that pregabalin carries these risks. How exactly does medicine familiarize itself with withdrawal other than case reports? GHB withdrawal is a common example. Not so long ago people argued that GHB did not induce addiction and withdrawal, and till this day the medical literature on treatment methodologies are lacking.

What are the predispositions that these individuals have in common?

Some are not mentioned, others substance abuse, others psychiatric illnesses, others have none. Again though, these are factors that contribute to every withdrawal.

It still doesn’t conclude that it is addictive...

So now not only are you refuting that it doesn't cause withdrawals, but it's not addictive?

Pregabalin is a novel gamma-aminobutyric acid (GABA) analog that is approved for the treatment of neuropathic pain and partial-onset seizures. While there are reports about the addictive potential of another novel antiepileptic drug (gabapentin [1, 2]), we present the first case of pregabalin dependence.

"Mr. B" was a 47-year-old man who asked for admission to the department for addiction medicine. At the time of his admission, he was consuming 25 capsules (equivalent to 7,500 mg) of pregabalin per day as well as alcohol and cannabis at irregular intervals. Attempting to wean himself off pregabalin, he developed vegetative withdrawal symptoms, including sweating, unrest, arterial hypertension, tremor, and craving for pregabalin. He fulfilled all seven DSM-IV dependence criteria. The patient reported a history of alcohol and cannabis abuse as well as heroin dependence but had been abstinent from heroin since he was released from prison 7 years ago. Two years ago, a friend suffering from neuropathic pain recommended that he use pregabalin, which in high doses would induce "very good feelings." Mr. B took some pregabalin capsules and experienced euphoric feelings. In the following weeks, his pregabalin use became regular, and he developed tolerance and withdrawal symptoms, which is why he finally increased the dosage to 25 capsules per day.

After admission to the unit, the patient's withdrawal symptoms were only insufficiently controlled by benzodiazepines. On the first day, we had to add pregabalin in high doses to achieve significant clinical improvement. His blood analysis immediately after admission showed a pregabalin level of 29 mg/l (therapeutic range: 0.5—16 mg/l). A breathalyzer test for alcohol was negative, urine drug test was positive for cannabis, and the patient stated that alcohol withdrawal symptoms were unknown to him. Standard laboratory, ECG, cranial magnetic resonance imaging, and abdominal ultrasound results were without pathological findings. An EEG revealed general alterations, probably because of the pregabalin's effect. Consecutively, pregabalin capsules were slowly reduced by two capsules a day. Within 12 days, Mr. B's plasma levels decreased from 29 mg/l to 9.8 mg/l. He repeatedly complained of a heavy craving for pregabalin, discontinued the treatment prematurely, and relapsed immediately at home by taking 20 capsules of the drug. Further attempts to motivate him for detoxification in our outpatient unit failed, and he continued taking up to 20 capsules per day.

Pregabalin is a GABA-analog that selectively binds to the alpha2 delta subunit of voltage-gated calcium channels. It inhibits the release of excitatory neurotransmitters and increases neuronal GABA levels. Like some other compounds that modulate GABA-ergic neurotransmission, pregabalin might have a potential for abuse. Our patient had a history of drug addiction, which may be important in the reward effect of pregabalin. We therefore recommend being especially cautious when using pregabalin to treat patients with a history of drug or alcohol dependence.

Source:http://ajp.psychiatryonline.org/article.aspx?articleID=102360

Tell that to Mr.B.

If it were as bad as most claim, some media would have hopped all over it in an attempt to gain good publicity

Seriously? The media? That's how you objectify a drugs withdrawal. In either case, there are a couple of news articles on pregabalin withdrawal I can dig up for you if you insist.

 

[Psychedelic Jay]

There are things that feel shitty to stop even though they are not euphoric and habitually used. So, yes addictive.

Even 5-htp can be habit forming for sleep...

Yet in still I’m on lyrica till this day, and as soon as it loses effectiveness, I quit for a certain period... No ill effects to note.
I can point to more people like I than any of this you are opening up to me.

Which I do appreciate by the way...

I do agree that drug and alcohol, are major in this...