How Lyrica Works for Fibromyalgia

woman pouring pills into her hand

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Lyrica (pregabalin) is a drug used to treat the pain of fibromyalgia. In addition, it's FDA approved for use in diabetic neuropathy and postherpetic neuralgia (shingles). It's also an anti-seizure medication.

The FDA approved Lyrica for fibromyalgia in June 2007, making it the first drug ever approved for this condition.

Lyrica is now one of three FDA-approved fibromyalgia drugs and is the only one that isn't classified as an antidepressant. The other medications are Cymbalta (duloxetine) and Savella (milnacipran).

How Lyrica Works

Fibromyalgia is believed to involve over-active nerves and dysregulation of neurotransmitters (chemical messengers) that transmit messages, including pain signals, between brain cells.

Scientists don't understand exactly how Lyrica improves fibromyalgia symptoms. However, the drug is believed to slow down certain impulses in the brain and stop over-active nerves from misfiring. It also may affect the way certain neurotransmitters function.

Lyrica for Fibromyalgia

Although it's been approved for several years, research has continued on Lyrica as a fibromyalgia treatment.

Of course, for it to be FDA approved, numerous clinical trials had to show that it could provide significant improvements in fibromyalgia pain, fatigue, and quality of life. However, Lyrica doesn't work for everyone with fibromyalgia.

In fact, a review published in 2016 found that Lyrica was moderately effective for 39% of study participants who took 300 mg a day, and 43% of those who took 600 mg a day. Those numbers seem fairly promising until you consider that 28% of people taking a placebo did just as well.

Some research suggests that the three FDA-approved fibromyalgia drugs—Lyrica, Cymbalta, and Savella—are all about equally effective. Combining two drugs may be more beneficial, though. A 2016 study published in the journal Pain suggests that combining Lyrica and Cymbalta may be more effective than either drug on its own, and the authors urged more research into combined treatments.

Dosage

The usual dose of Lyrica for fibromyalgia is 300 mg to 600 mg per day, split between two or three doses. Generally, doctors recommend starting at a low dosage, such as 75 mg twice a day, and working up gradually to a larger dose.

If you decide to go off of Lyrica, talk to your doctor about the proper way to wean off. It's dangerous to stop taking Lyrica suddenly.

Side Effects

The list of possible side effects is long. Some are serious enough that you should contact your doctor immediately if you have them. They include:

  • Allergic reactions (rash, itching, hives, swollen face, lips or tongue)
  • Anxiety/confusion
  • Breathing problems
  • Vision changes
  • Chest pain
  • Unusual involuntary movements
  • Memory loss
  • Muscle pain, tenderness or weakness
  • Tremors
  • Unusual bruising or bleeding
  • Thoughts of suicide or dying
  • Mood changes

More common Lyrica side effects, which usually do not require medical attention, include:

  • Constipation or diarrhea
  • Dry mouth
  • Headache
  • Insomnia
  • Nausea
  • Weight gain

Research has found that Lyrica rarely causes negative interactions with other drugs and that it appears to be safe when combined with antidepressants.

A Word From Verywell

You and your doctor are the only ones who can determine whether you should give Lyrica a try. Know that it can be expensive and some insurance companies won't pay for it.

It's also a good idea, when you start a new medication, to have your pharmacist look over your drug list for any possible negative interactions. You may also want to consider keeping a list of side effects handy so you can quickly identify whether you're having any dangerous ones.

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Article Sources
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  1. Food and Drug Administration. Lyrica.

  2. Food and Drug Administration. Living with Fibromyalgia, Drugs Approved to Manage Pain.

  3. Boomershine C. Pregabalin for the management of fibromyalgia syndromeJournal of Pain Research. 2010:81. doi:10.2147/jpr.s7884

  4. Derry S, Cording M, Wiffen PJ, Law S, Phillips T, Moore RA. Pregabalin for Pain in Fibromyalgia in Adults. Cochrane Database Syst Rev. 2016;9:CD011790. doi: 10.1002/14651858.CD011790.pub2

  5. Gilron I, Chaparro LE, Tu D, et al. Combination of Pregabalin With Duloxetine for Fibromyalgia: A Randomized Controlled Trial. 2016;157(7):1532-40. doi:10.1097/j.pain.0000000000000558.

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