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Bipolar - Lyrica Pregabalin vs. Neurontin Gabapentin

  • Thread starter Thread starter preGABApentin
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preGABApentin

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I am prescribed neurontin or gabapentin for bipolar (+ comorbidities), and there are numerous psychiatric studies on its effectiveness, although many naturally yield different conclusions. Let us assume for our purposes that it is effective as a mood stabilizer/anti-manic/anti-anxiolytic.

I am aware that lyrica or pregabalin is the successor, but there are not many, if any, studies done on its efficacy in bipolar. I find this strange to say the least, but that's not important. It makes sense (to most of us im sure) that their unique and similar pharmacodynamics would exhibit the same effect, but since there is not much data that I could find on the subject I thought I would ask here:

1. Has anyone with bipolar taken lyrica? Please give your reaction.

2. More importantly, has anyone who is/was on neurontin for bipolar ever tried lyrica to compare their efficacy?

3. Lastly, does anyone see or know of pharmacological differences between the two aside from mg:mg potency?

I really didnt' see much difference between the chemicals. They both are alpha2delta calcium channel binders and lyrica seems to be metabolized better or has higher bioavailability, but that's all I could find or deduce. The main difference to me seems to be dosing windows based on chemical strength. In a similar way that benzos require different dosages for similar effect even though their basic pharmacologies are the same (e.g. 1mg clonazepam = 10-20 mgs diazpeam, etc...)

What Im really asking here is what are the pharm similarities/differences and if lyrica is effective treatment for bipolar.

Thanks very much
(mod: ADD shift please)
 
I am diagnosed with Bipolar type 2 comorbid with dysthemia and Generalized Anxiety.

While I don't buy an ounce of this psychobabble shit, I will concede that I have an unstable mood.

I have tried both Gabapentin and Pregabalin, and found the former to be almost a miracle-cure for my mood problems. Pregabalin works too, but has too many side effects (for me), especially concerning memory (they are so severe as to be comparable to PCP!!).

Hope this helps, YMMV.
 
re:Bipolar Lyrica/pregabalin vs neurtonin/gabapentin

Hey Jamshyd

I totally agree with you on the psychobabble bullshit. while i also agree that there are simply "mood disorders," I think they can be simply viewed as the same issues on one spectrum and each individual's 'illness' emphasizes certain aspects or qualities of that disorder spectrum. that may be too reductionist for clinical applications, but then again, theory, terms, and definitions are simply sets of words for specific application sets, right?

Anyway, back to the topic. I find gabapentin to be the most amazing drug i've tried. it has the effects of a weak/small dose antipsych, pretty much just like a mood stabilizer, but i get no other side effects really (no zombification, actually quite the opposite, and no somnolence or unwanted sedation). all i know is, i told the my new psych, "im done with the atypicals as well as the classical anticonvulsant mood stabs, so if you dont have anything to offer me, i would like to begin my tapering off all meds." he quickly suggested neurontin, which i thought was strange when he knew that i was already anti-mood stab/anti-psychs and he had a benign alternative. of course its mostly off-label prescriptions, but so is everything for lyrica/neurontin.

Jam, you say that you like neurontin more because it has less side effects. What side effects do you experience on both of these meds? I have only been a little discoordinated/"drunkish" walking at times, and I am only on 600mgs a day (I have bipolar w/psychotic feat.)

Also, what is your daily dose? I read that for bipolar they usually stick you at a minimum of 900 tid, but i am only at 600mg qd, which seems really low. I feel its working, and I dont wanna exceed my daily dose at all unless under his supervision, but because of the half life, Im thinking of taking 300mg bid (1 in the morning on waking and then 300mg in early afternoon). Do you think that might be a good idea because as it wears off, symptom remission isnt as pronounced.

Anyway, to summarize this nonsense of a long post, and i do apologize (im just finally glad im on something that is benign and non toxic and actually works without bad side effects for once)

1) What are side effects on both lyrica and neurontin for you like?
2) What is your daily dosage and how do you dose?

Thanks very much Jam
 
Yeah, I've found gabapentin to be great for my mood. But is it effective for treating bipolar disorder? Absolutely not. Not one study of any importance has found it to be effective. Tiny studies find it to be- occasionally, but the big ones are unanimous- it is not effective.

Bipolar 2 may find it more effective, since it raises the mood well, and doesn't produce mania. However for anyone dealing with mania very often, it's completely ineffective.
 
reBipolar - Lyrica Pregabalin vs. Neurontin Gabapentin

(mod: sorry for the second anon post, i forgot to ask this question so you can merge with the last responses if you want, if thatll make it easier)

Jam, i noticed that you said lyrica/neurontin works well with amphetamine. is there anything you an add to this, maybe elaboriate on either effects or health/metabolic interactions risks?

thanks again very much jamshyd
 
I have been diagnosed with bipolar disorder, though I've had other psychologists tell me that I don't have it. I don't know, really. Anyway, I was prescribed gabapentin and while I found it a good, relaxing sedative, I didn't find it terribly useful in the treatment of my mood.

What the alpha-2-delta calcium channel has to do with bipolar disorder is kind of a mystery too. As far as I know, the debate on their function psychopharmaceutically endures.

There is a short review here that specifies it may be useful for anxiety disorders: http://www.psychiatrictimes.com/anxiety/article/10168/1370782

(On an aside, it also causes some pretty crazy visuals for me when combined with opiates, and I still don't understand the root cause of that.)
 
hammilton said:
But is it effective for treating bipolar disorder?
Click to expand...

Well...we don't really know what causes the 'disorder', how to think of heterogeneity within it, etc. Medications established as 'effective' are pretty much aggregated trial and error.
 
I have bipolar 2 disorder and i get pretty bad mixed states, mania and some psychotic symptoms with bad episodes. Ive taken both gabapentin and lyrica and i found both to do absolutly nothing for my mood and gabapentin was beyond useless as a mood stabilizer.

In fact im pretty sure gabapentin makes me more depressed sometimes. Lyrica although it didnt improve my bipolar disorder atleast seems not to have a negative effect on it. I don't take these meds for bipolar disorder by the way i take them for trigeminal neuralgia.

On an aside, it also causes some pretty crazy visuals for me when combined with opiates, and I still don't understand the root cause of that.)
Click to expand...

Funny that you mention that but both lyrica and gabapentin sometimes mess my vision up really bad when taken with opiates. Both gabapentin and lyrica are great opiate potentiators especially if taken after you take morphine. Though lyrica is the winner for sure.

If i take either alone or with a benzo in high doses to catch a buzz it's then that my vision really goes to shit and i do get weird flashes of light sometimes.
 
Since the two compounds are very similar:

If gabapentin(GB) works for you improvements from lyrica(LY) would be related to a more steady and predictable level of absorption.

GB is not absorbed well or predictable in high doses and often has to be doses more often at lower doses during the day. This injects more human error into your plasma levels as you may not always take it at the same time, temporal distance from last dose.

LY would probably be a good decision if you feel like your still having ups and downs.
Give it a shot. THe real fact of the matter is they are similar but not the same and mood stuff is highly personal. you wont know until you try and good luck.

I'd like to give you a better response but I've only used the drug for pain. Worked well and pretty much exactly the same as GB for me.
 
ebola? said:
Well...we don't really know what causes the 'disorder', how to think of heterogeneity within it, etc. Medications established as 'effective' are pretty much aggregated trial and error.
Click to expand...

One thing that is well established: anticonvulsants inhibiting voltage-gated sodium channels are effective, those inhibiting calcium channels are not.
 
A friend of mine is Bipolar 2 and takes gabapentin 400 mg t.i.d. for anxiety issues (which seems to actually be working reasonably well). It seems to stabilize his mood, but only marginally. I largely attribute any mood stabilization to the Lamictal that he takes with the gabapentin. Perhaps the gabapentin is making the Lamictal slightly more effective, I'm not quite sure. Doubtful though. Surprisingly, loxapine, which has recently been added to his regimen has oddly had a mood-stabilizing effect. I'd say that this can be best attributed to a control of psychiatric agitation that negatively impacted mood.

I myself am Bipolar 1 and am on Tegretol as my anti-convulsant mood stabilizer. I've tried gabapentin and Lyrica briefly and found them both to be absolutely useless and if anything, impaired my cognition. Lyrica and gabapentin did absolutely nothing for my mood whatsoever, however I did receive the full range of side effects from both.

Oddly enough, both Lyrica and gabapentin did have a very slight anxiolytic effect, although not one of any tremendous note or therapeutic usefulness. Plus I found that with Lyrica especially, anxiolysis came at the cost of significant cognitive impairment.

In all honesty, 2 mg of clonazepam added to my med regimen has had a greater mood-stabilizing effect in conjunction with the Tegretol than did the Lyrica or gabapentin. My mood seems to be more even keeled, but not in a manner that can be attributed to benzo-induced calmness/agitation reduction.

I think the bottom line is that it appears as though gabapentin and Lyrica work well for Bipolar 2 patients for both mood in some cohorts and anxiolysis in most cohorts but appears to be rather useless for Bipolar 1 patients.
 
^ I have taken Lamictal with and without Gabapentin, and found it detrimental altogether. The former made me feel very, VERY stupid, slow, and little (in a bad way). On day 5 or 7 or something, I grabbed the damned bottle and watched gleefully as its contents splattered down into my toilet, and then... ah, ecstasy in flushing!

I put Lamictal in the same place I put Buspirone, ie. so useless that even flushing it down the toilet may endanger the little brains of mice and rats and roaches that dwell in the sewers that it eventually reaches...
 
on the subject of bipolar, the dsm manual is just endlessly convoluted and full of stupid categorisations as a result of anal gimps. with it you either have it or you dont and the severity is on a continum like a bell curve with fluctuating severity over your life depending on a multitude of factors.

i have been diagnosed and never taken antispchotics (apart from ones i stole off a friend when raging manic). i have had one very severe manic episode and the rest have been bad but not in the same ball park (although mybe i dont remeber them for a reason). you have to accept that your mood will swing and put effort into your thinking to help control the socially unnacceptable effects upon other people. also you need to AVOID ALCOHOL at all costs and try and make your diet as good as possible. strong b vitamin complex helps control the insomnia and temper (b6 is used to make serotonin and dopamine, if you run out it wont be pleasant). attempt to limit the stressors in your life (like crippling shift patterns and losing your social life to work), and always try to get enough sleep.

mood stabilisers are essential (i find tramadol with its anti depressant uplifting, and mild opiate paranoia destroying effects works better than anything i ever had). this illness can be to your advantage as the creativity and drive it gives you set you apart but its hard work and i feel alienated almost all the time (but with tramadol instead of crying i can use objective logic to see my thoughts for what they are, and get them to a manageable level). it is managable although i find that benzo's and tranqs make it more difficult to control as my control of it comes from awareness of myself and the boiling moods are always ready to burst i just have to keep a lid on it, disinhibition doesn't help this aspect at all.
 
I've never taken pregbalin but gabapentin has changed my life. I have bipolar II and it helps diminish the anxiety and apathy I often feel. The "high" goes away quickly but the positive mood lift remains. I want to try Lyrica and see what happens.
 
Sorry for bumping an ancient thread, google brought me here. I'm Bipolar 1 with the occasional psychotic episode, currently on lithium and buprenorphine. Had a couple of teeth pulled, got dry socket and ended up getting some Lyrica from a friend for the pain. I was blown away by the effects. Sort of felt like hypomania but never went any further than that. Happy, talkative, slightly euphoric and thoroughly enjoying music all night long.

I will definitely have to ask my psychiatrist if it's possible to get this stuff off-label as a mood drug. Feeling that good has become so rare in recent years (f%¤#ing lithium), I was almost in tears when I realized it'll end soon. The bupe was originally great but that didn't last, it's more like a burden now. Not much in the way of positive effects, too low a dose and I'm afraid to even think how addicted I am (several years of street Subutex before getting the prescription).

Some poly people do a lot of pregabalin here but others say they get nothing from it. Strangely I also got no effects from it when I first tried it several years ago. Now there is definitely a huge effect on mood for me. I'm hoping abuse isn't an issue with the doctors as it is for any opioid by default.

How bad is dependence/withdrawal with pregabalin? I'm sick and tired of this grey existence that lithium brings. It prevents episodes completely but makes life shit.
 
My ex-girlfriend trialed it as a mood stabilizer because of its supposed less teratogenic effects in case she accidentally got pregnant, she strongly tended towards the hypomanic side of things and didn't find it too effective. It did something at 75mg a day, but it couldn't come close to fully replacing her valproate without excess sedation.

Of course YMMV, but gabapentin is very similar and less likely to set off a redflag if you ask for it. But, looking at Lyrica's mechanism of action your positive experience seems more likely to be the result of it potentiating your buprenorphine. Its definitely worth a shot as both are gaining rapid acceptance as mood drugs, but don't be surprised if there's a rapid tolerance.
 
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