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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Caedmon on April 25, 2006, at 23:48:57
So, what is the difference between Neurontin (gabapentin) and Lyrica (pregabalin)? I know that they are supposed to be similar structurally and wrt their mechanisms of action. Lyrica has better bioavailability at higher doses. Is that it?
I seem to hear better things about Lyrica than Neurontin, maybe because it's new. BUT, don't they pretty much do the same thing?
- C
Posted by yxibow on April 26, 2006, at 3:00:26
In reply to Neurontin vs. Lyrica, posted by Caedmon on April 25, 2006, at 23:48:57
> So, what is the difference between Neurontin (gabapentin) and Lyrica (pregabalin)? I know that they are supposed to be similar structurally and wrt their mechanisms of action. Lyrica has better bioavailability at higher doses. Is that it?
>
> I seem to hear better things about Lyrica than Neurontin, maybe because it's new. BUT, don't they pretty much do the same thing?
>
> - CThe only similarity between the two drugs is that they're both manufactured by Pfizer and they are both being pursued and marketed for various forms of neuropathic pain equally besides for epilepsy.
They are different structurally. Neurontin, gabapentin, is an isomer of GABA itself that can cross the blood-brain barrier unlike GABA supplements.
Lyrica, Pregabalin, while having only one more Carbon atom than Neurontin works a litte bit differently. However, they both bind to the A2D subunit of voltage-gated calcium channels.
Neurontin is a DEA unscheduled Rx drug, Lyrica is a DEA schedule V Rx drug. It is very unusual for any drug to be put into Schedule V. It originally was going to be C-IV but I guess the FDA changed its mind and it is C-V. Some people found Lyrica "euphoric" in a test and it was enough to Schedule it. Go figure the DEA/FDA.
Neurontin has less side effects than Lyrica, however Lyrica could be more effective than Neurontin in some individuals so I suppose this stands to reason. Neurontin is eliminated by the body after a certain point and is useless beyond that while Lyrica has a nearly linear dose to elimination line.
Lyrica, just like any other AED can actually potentiate seizures if too many other GABAnergic drugs are in the polypharmacy though not nearly like Gabatril.
Besides more somnolescence and the usual such things that accompany more soporific agents, Lyrica has about a 10% side effect of blurred vision. Extreme rare cases cause other eye related disorders.
So, I enter the brave new world of Lyrica. We're going very slowly as it is uncharted territory psychiatrically at large, at the moment. I'm not near any therapeutic dose, just at a test range at the moment. If it has any benefits and I dont have much eye issues than maybe I can reduce the other GABA agents in my profile.
So that's basically the two in a nutshell
Cheers
-- Jay
Posted by willyee on April 26, 2006, at 6:06:57
In reply to Re: Neurontin vs. Lyrica » Caedmon, posted by yxibow on April 26, 2006, at 3:00:26
Great post thanks for taking the time to compare the two in the most lamon way u could,i still have trouble knowing the main differeance of the two and this helped a lot.
Posted by Cairo on April 26, 2006, at 7:21:11
In reply to Neurontin vs. Lyrica, posted by Caedmon on April 25, 2006, at 23:48:57
I'll share my Neurontin and Lyrica experiences with you.
With Neurontin, I had no trouble ramping up the dose very quickly. I am increasing Lyrica much slower as unsteadiness is a problem.
Both cause blurred vision in me, especially in the afternoons, but I also have very dry eyes which can cause blurred vision.
No euphoria with Neurontin, but there's the hint of it with Lyrica.
Neurontin overall caused more fatigue, though Lyrica had very noticeable fatigue at first, but now it almost seems energizing at a higher dose.
Weight gain with both, with Lyrica a little faster and with each dosage increase :(
Both have a mild calming, anti-anxiety effect.
No blood pressure problems with Neurontin, but I'm needing to decrease my atenolol dose with Lyrica, as blood pressure is getting too low, thus the unsteadiness, I guess. I will say that my BP is a little more labile nowadays anyway, so this may be due to other factors than the Lyrica.
Neurontin seemed to act very quickly in terms of muscle relaxation, Lyrica takes a week or so before I experienced this effect or others (also with dosage increases).
Both improve sleep when taken along with Desyrel. Neurontin's sleep seemed better as I'm still waking up tired with Lyrica/Desyrel, but it may be due to the fact that my symptoms are more severe now in general.
Both cause a degree of numbness in the extremeties and some edema (again, maybe causing weight gain).
I'm currently on 100mg Lyrica in the AM and 150mg at night, with 450mg per day being my goal (for chronic pain).
I was able to eliminate Klonopin for panic attacks while ramping up the Lyrica, but I'm experiencing flushing again a bit, but I think we need to look at other factors here such as oversensitive beta receptors or something. All in all, I like the Lyrica, but I don't think it's the whole answer for me.
Cairo
Posted by Crazy Horse on April 26, 2006, at 7:40:14
In reply to Neurontin vs. Lyrica, posted by Caedmon on April 25, 2006, at 23:48:57
> I seem to hear better things about Lyrica than Neurontin, maybe because it's new. BUT, don't they pretty much do the same thing?
I have been on both. Lyrica is much stronger, excellent for anxiety disorders. I never really could tell if neurontin was working or not...with Lyrica, trust me it works! Of course as always this is just my experience with these drugs. I've heard that they are both manufactured by the same company..and that Lyrica is pretty much going to replace Neurontin.Monte
Posted by ed_uk on April 26, 2006, at 9:39:46
In reply to Neurontin vs. Lyrica, posted by Caedmon on April 25, 2006, at 23:48:57
Hi C
Pregabalin (Lyrica) and gabapentin (Neurontin) appear to have the same mechanism of action. Both drugs bind to the alpha-2-delta subunit of voltage-gated calcium channels in the central nervous system.
Pregabalin is new and expensive. In the UK, gabapentin is available as a generic - the price is falling :)
Regards
Ed
Posted by Greif on April 26, 2006, at 12:31:55
In reply to Re: Neurontin vs. Lyrica » Caedmon, posted by yxibow on April 26, 2006, at 3:00:26
Well done. I tried Lyrica for about 4 weeks. It produced a high energy boost removing any depression. I had switched from Lexapro at Docs advice. It was great at first but when I hit 200 the cognitive side effects were almost disabling. Back on the Lex with Klon for the duration. There are some new meds on the horizen that work differently than the anti-convulsants or benzos. Until then i have achieved and balance in my mood that I have not had since I was a teenager. Thanks again. Best comparitive post one could hope for.
Posted by Phillipa on April 26, 2006, at 20:16:05
In reply to Re: Neurontin vs. Lyrica yxibow, posted by Greif on April 26, 2006, at 12:31:55
Lost me. Love Phillipa
Posted by yxibow on April 27, 2006, at 12:28:50
In reply to Re: Neurontin vs. Lyrica yxibow, posted by Phillipa on April 26, 2006, at 20:16:05
> Lost me. Love Phillipa
Sorry, just trying to describe them in the most succinct manner that I can :)
Ed shortened it and basically said Lyrica is more expensive. Which is true, I can tell you that a certain unnamed insurance company is paying 60% of a $2 pill. And all values of the drug are the same price.
Posted by GreenP on July 5, 2010, at 3:26:31
In reply to Re: Neurontin vs. Lyrica » Caedmon, posted by Crazy Horse on April 26, 2006, at 7:40:14
Lyrica actually is Neurontin, they are the same thing except Lyrica is longer acting and obviously a stronger dose. It was made to replace Neurontin because it lasts much longer. Trouble is, it is much more expensive to buy.
Posted by humanPDR on July 11, 2010, at 22:44:02
In reply to Re: Neurontin vs. Lyrica, posted by GreenP on July 5, 2010, at 3:26:31
Having tried both Lyrica and Neurontin at varying doses, I have to say that the therapeutic effects are nearly identical. Lyrica is more potent, producing noticeable anxiolysis in the 150-400 mg range, as opposed to 1,200-2,400 mg dose for gabapentin.
In terms of adverse effects, Lyrica is worse (in my particular case...each person's response is diff). The worst problem was the rapid weight gain and a huge increase in appetite. I could literally stuff my face with a giant meal and be starving 20 minutes later...I gained 10 lbs in 2 weeks while running 2 miles/day and weight-lifting. The water retention/edema is also very annoying.
In my experience, Lyrica and Neurontin are pretty much identical in terms of the therapeutic effects. I don't like either, as they turn me into a walking zombie with marginal anxiolytic activity at best.
Cheers
Posted by Phillipa on July 12, 2010, at 0:03:35
In reply to Re: Neurontin vs. Lyrica, posted by humanPDR on July 11, 2010, at 22:44:02
Seriouly love your posting name. I knew about swelling but didn't know about weight gain. Well benzos anyway. 40 years later still on low doses. Phillipa
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