Posted on 12/23/2022 12:39:06 PM PST by ConservativeMind
A study suggests two anticonvulsants often prescribed for chronic pain are only "modestly effective" at pain management and can create an unfavorable risk/reward situation for patients.
The findings are important because prescriptions for the drugs, gabapentin and pregabalin, have been on the rise as the U.S. tries to move away from opioids amid an ongoing opioid epidemic.
The study also found in randomized trials, patients on placebos tended to report one-third to one-half the pain reduction benefit of patients receiving gabapentin or pregabalin.
The findings highlight challenges involving studies and trials used by the FDA when it considers approving a drug. The study also sheds light on the consequences of the shift away from opioids and the practice of "off-label" prescribing.
The research by Craig Williams looked at a pair of anticonvulsant medications that work the same way in the body. They bind to a certain protein in cells of the central nervous system, alleviating seizures, and in some cases they also relieve neuropathic pain caused by peripheral nervous system activation or dysfunction.
Gabapentin is available under multiple brand names including Neurontin, and pregabalin is commonly sold as Lyrica.
They found gabapentin, which the FDA rejected as a diabetic peripheral neuropathy drug, and pregabalin were similarly effective at controlling pain when compared in studies head-to-head. That is not surprising given that they work the same way, said Williams.
Numbers from the Agency for Health Care Research and Quality note that 20% of Americans with chronic pain are taking a gabapentinoid.
"New guidance from the CDC to be released soon is expected to call for even greater use of non-opioid analgesics including gabapentinoids," Williams said. "But data regarding the use of these drugs for chronic pain is limited, and instances of inappropriate marketing for off-label pain uses are well documented."
(Excerpt) Read more at medicalxpress.com ...
These 2 are the VA 1st line protocol for neuropathy. Gabapentin was horrible for me. I’ve fixed some stuff since then. I start on Lyrica as soon as it shows up in the mail.
2 weeks ago I was at the clinic as an ER walk in. HA! Sciatica had my whole right side turned to stone I could barely walk. Toridol in one ass cheek, prednisolone in the other.
It’s tons better than it used to be but sometimes it will not be denied or ignored.
I take a couple of 300 mg a day. Mom takes one. Seems like plenty
What is your neuropathy from?
I suffer from minor seizures and sciatic nerve pain. Gabapentin is a godsend.
This article is bunk.
I love the drug threads.
Gabb in those doses will cause extreme weight gain and swelling
I was on Gabapentin for a while, it helped with burning on my side and
it helped when I got shingles. It
numbs the area, worked fine except
that it made me feel loopy.
No đ©.
Now prob pre-diabetes. Not sure what caused it before but my legs have always been painful.
Yes to that!
Why?
My doctor keeps trying to prescribe me Gabapentin. I’m not sure why. I tried it years ago and told him that no only did it not work, it made me feel miserable. My mother and all my siblings have different medical issues and we all go to different physicians. But, every single one of my siblings and my mom have been prescribed Gabapentin. It’s apparently just the flavor of the month that the pharmacy reps have been able to keep flowing for years, regardless of the fact that it doesn’t work for pain and has side-effects that makes pain actually worse for some people.
“The âopioid epidemicâ is 90% from illegal Fentanyl (107,000 deaths in 2022), while Rx opioids are needed for pain management, and tiny in comparison with Fentanyl.”
+++++
It ticks me off that they conflate the two totally different drugs. Many people take a maintenance dose of an opiod medicine to help them function daily while working through the pain. Without the drug, their pain would be so intense they would be bed-ridden. The “opiod epidemic” is due to illegal drugs coming across the border to be abused by drug addicts. Two separate things. However, it’s easier to go after the cancer patient who is taking 4 opiod pills a day in order to manage their pain, rather than close the border and stop the drug traffiking. These overdoses we hear about daily are, for the most part, illegal drugs such as fentanyl, not little ole grandpa’s prescription of pain medicine he takes for his busted knee and bad back.
It did nothing. No side effects, but no relief. Dr. then said to take 2400mg of gaba, or 2200mg of NaproxenâŠ. No thanks â recommended max of naproxen sodium is 2000, and even that is kidney-trashing!
Iâm taking 440mg of Naproxen, hurt all the time, and just deal with it. Iâve given up on VA, getting (and paying for) Medicare advantage. VA is fine if you need major stuff (surgery) and canât afford it, but for ongoing routine health care, youâre better off with a dang Merck Manual!
ââŠdizziness, confusion, drowsiness and dangerous breathing problems.â
Ditto,ditto,ditto
I think not all pain comes from the same cause, and gabapentin works relieving some types of swelling on the sciatic nerve, maybe as a muscle relaxant
But not on all types of inflammatory pain
100% spot on.
My PCP (Primary Care Provider) Dr is in the Wellspan System, here in York, and told me that the DEA mandated almost zero Rx opioids for their patients — few exceptions — but meanwhile the Fentanyl pours-in the wide-open border, unabated.
Dosages and pill strength have been cut way back, or ended, for so many Americans who desperately need it to function and live.
Bidet&Co have a $ deal with the cartels to allow it, with some notable interdictions for PR/news purposes. Trump had it slowed to a trickle; now, it’s a tsunami and 2023’s death number will dwarf the 107,000 from this year.
True, everyone is different.
Following a neck injury, my doctor added the muscle relaxer Tizandine. It puts me to sleep and helps with the pain.
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