Pregabalin/Lyrica attenuation of opiate withdrawals

[endotheogen]

Non intentionally we have been finding that pregabalin reduces mild opiate withdrawals, specifically cold sweating. It would be interesting to see if anyone else has experience with this or understand its mechanism of action and why it's affecting the opiate receptors. Taken at night time during mild withdrawals it lessens the withdrawals and knocks one out to sleep, coupled with obvious anti-depressant qualities the next day or so (these fade after continual use) - seemingly more effective than diazepam which only makes you groggy. It's prescribed for nerve pain.

[Alchemica]

I was on 300mg/day pregabalin when I was going through tianeptine withdrawals (1g/day) and it was still hell. I've heard others find pregabalin useful but I'm not sure if it's more the acute effects where you 'feel' it that are the useful part for withdrawals? Once you have a tolerance built up, I'm not sure?

The anxiolytic effects from VDCC blockade are generally useful and pregabalin has the general property of reducing excitatory neurotransmission which is likely beneficial in a withdrawal state. I'll have to do some reading and get back to you if I find anything worth mentioning.

Thanks for sharing

[Alchemica]

 

[Pregabalin for the reduction of opiate withdrawal symptoms].

Pregabalin is a substance which modulates monoamine release in "hyper-excited" neurons. It binds potently to the α2-δ subunit of calcium channels. Pilotstudies on alcohol- and benzodiazepine dependent patients reported a reduction of withdrawal symptoms through Pregabalin. To our knowledge, no studies have been conducted so far assessing this effect in opiate dependent patients. We report the case of a 43-year-old patient with Pregabalin intake during opiate withdrawal. Multiple inpatient and outpatient detoxifications from maintenance replacement therapy with Buprenorphine in order to reach complete abstinence did not show success because of extended withdrawal symptoms and repeated drug intake. Finally he disrupted his heroine intake with a simultaneously self administration of 300  mg Pregabalin per day and was able to control the withdrawal symptoms. In this time we did control the Pregabalin level in serum and urine in our outpatient clinic. In the course the patient reported that he could treat further relapse with opiate or opioids with Pregabalin successful. This case shows first details for Pregabalin to relief withdrawal symptoms in opiate withdrawal.

 

Similarly, gabapentin is useful.

Edited June 27, 2016 by Alchemica

[Bruce]

If someone is on both lyrica and opioids for pain, does the lyrica interfere with the opioid doing it's job? ?

[Alchemica]

It seems pregabalin is beneficial in reducing tolerance to the effects of opioids "These data show that pregabalin has a potential anti-tolerant/anti-dependence property against chronic usage of morphine. Therefore, pregabalin appears to be a promising candidate for the treatment of opioid addiction after confirming by future clinical studies." [1]

 

I'd say it would be a useful synergy for pain relief rather than interfering with the opioid?

[Bruce]

 Ok, so if a specialist pain doctor recommends cutting out opioids because they they don't work well in nerve/ chronic pain and replace it with deep breathing.   Should you be looking for a new specialist because he's crazy?  Or, doesn't he believe the pain is real?  The doctor referenced a study published in 2014 on opioids and their relation to chronic pain.   One of the main points was that doctors are stuck in a rut since early 1930's 1940's when they were treating cancer patients and couldn't do anything.  The family's demanded pain relief.  Doctors gave the patients morphine but not for pain relief.  It was so they would "Feel good"  

Sorry about dumb question befor.  I know they work together.  I just sat down to ask something else and I forgot what I was going to ask.  Then that question popped into my head.  Thats a big problem with Lyrica.  Your memory goes to the dogs.  

What I was going to ask was.  If you are on both lyrica and opioids and you come off the opioids .  Is the lyrica going to lessen the opioid withholding? or because of the regular use, will it have no beneficial effects?  

Edited June 27, 2016 by Bruce
Lyrica

[Alchemica]

I'm no expert on good options for pain relief strategies, hoping others can chime in for you @Bruce

As for the lyrica lessening the withdrawal, my experience is that it was still hell to go through on it and none of the strategies I had available or explored seemed to do much to help it. Keeping it simple, accepting that it's going to be a really rough time and a bit of diazepam (even clonidine) seems to be the better option IMO,

[Anodyne]

On 27/06/2016 at 7:58 PM, Bruce said:

 Ok, so if a specialist pain doctor recommends cutting out opioids because they they don't work well in nerve/ chronic pain and replace it with deep breathing.   Should you be looking for a new specialist because he's crazy?  Or, doesn't he believe the pain is real? 

They probably believe you. Most likely that isn't the issue. The issue is that opioids really are not a great long-term solution because of tolerance. Believe me, I've got chronic pain issues & am a big fan of opioids & absolutely wish that this were not the case, but unfortunately it is. In fact, if you're unlucky, you can even end up in more pain ("opioid-induced hyperalgesia") - it's as if your body decides "hey, I'm sending all these pain signals but the message isn't getting thru, guess I need to turn up the volume". Or something.

 

I was lucky enough to be referred to a pain management clinic after a few years, and they have been suggesting some nifty breathing & meditation techniques. They're good at dealing with crotchetty people in lots of pain, and supportive without being indulgent. They're also big on "radical acceptance" and have been helping me make other mindset & lifestyle changes to adapt. Because they're right, if you're at the point where your pain is being labellled "chronic", then it's probably here to stay, and loading up on opioids is only a short-term solution. In the end you're either going to have to work out how to live with it, or break. In my case I did both, but the meltdown passed & the acceptance remained.

[sagiXsagi]

I took lyrica for many months this year at 300mg per day for disc herniation pain. Works wonders for pain. Didn't have any side effects coming off it. Well, as soon as I stopped, my libido came to normal levels again. 

 

In my reading I found it also seems to work with generalised anxiety, and with opiate withdrawals, as well as in combination with opiates in pain management, when tolerance is an issue. Thus is seems to partly solve tolerance issues , or at least for a while, by reducing the opiate dose and combining it with lyrica. Lyrica is supposed to cause dependance when used for extended periods of time, say over a year... 

 

I haven't ever used opiates, and I hope I never need it for pain..

 

Lyrica is a pretty mood enhancing drug by itself when you increase dosage from 75 to 150 mg per day , more so when you increase from 150 to 300 per day.. dose increases should be gradual, but in general I found the feeling of these days after upping of the dose very nice and blissful.. 

 

Well I was not on opiate withdrawals, but I was stuck to bed, for a second year in a row, watching films and series, seeing people rarely etc... I had no serious pain, but my movements were very limited...  well it felt pretty well with the lyrica.

 

Combination with alchol was mad at first, lyrica seems to potentiate everyting from alcohol to opiates to pot. drugforums have decent info on pergabalin 

 

Junkies in my area know it and use it (if they can find it) to battle withdrawals when they trying to cut or when they cant score anything. 

Edited July 1, 2016 by sagiXsagi