[rpaddock]

One of the known side effects of this drug is Suicidal Ideation.

My late wife was taking this crap when she killed herself; see the documentary Pain Warriors for that whole saga.

I've been warning people about this drug for years. One lady told me, months after a warning to her group: "Bob, I was standing on the railing of a bridge ready to jump, when I heard your voice. I got off of the bridge and got help."

This stuff really needs to be removed from the market. I acknowledge that I've been told by a very few that it helps them. I've been told by far more how it harmed them.

See also from the Journal Cell Oct 16 2009, relating to both Gabapentin and Lyrica, because other comments here are speculating about how it works:

"... α2δ-1 is the high-affinity receptor for two commonly prescribed antiepileptic, antineuropathic pain medications, gabapentin (GBP, Neurontin) and pregabalin (Lyrica) (Gee et al., 1996). GBP and pregabalin were initially designed as hydrophobic gamma amino butyric acid (GABA) analogs that could cross the blood-brain barrier. Further studies have shown that even though they posses anticonvulsant properties, they do not bind to GABA receptors or transporters. A recent study using a knockin mouse that expresses a mutant α2δ-1 that cannot bind GBP or pregabalin has shown that α2δ-1 is the in vivo target for these drugs and that these drugs mediate their therapeutic action through binding to α2δ-1 (Field et al., 2006). GBP and pregabalin do not affect the single-channel kinetics of calcium channels and have only modest effects on neurotransmission (Dooley et al., 2007). Thus, the cellular mechanisms underlying the mode of action of these drugs are unclear. ..."

https://www.cell.com/cell/fulltext/S0092-8674(09)01185-4

[theragra]

All antidepressants cause same, and evidence that they work is not awesome (they work barely better then placebo) The question is should the whole industry be destroyed, or what?

Very hard things to solve. Opioids help with pain, but destroy lives in the long term. Should they be almost never prescribed, except in severe pain and never longer then a week (except in hospice?)

More questions then answers

[stacktrust]

The smallest capsule of pregabalin/lyrica is 25mg. After reducing to that minimum, it still took months of further tapering by dividing capsules, before withdrawal symptoms ended in one elderly patient. Pregabalin suppresses nausea, which means nausea is a symptom of withdrawal, requiring ginger tablets or other anti-nausea assistance during tapering.

https://www.thetimes.com/uk/article/an-anxiety-drug-killed-m...

> An investigation by The Sunday Times has revealed that pregabalin has the fastest-rising death toll of any drug in the UK, based on figures compiled from official data across all regions. It is detected in a third of all drug-related deaths. In 2012, pregabalin was indicated in nine fatalities. A decade later, in 2022, the number had risen to 779, with almost 3,400 deaths in the past five years.

[rpaddock]

Yet sadly it is still on the market. Is there a number of deaths that are enough?

There is also this small 2016 study:

"Interference with neuronal development

Pregnancy outcome following maternal exposure to pregabalin may call for concern

ABSTRACT

Objective: To investigate pregnancy outcomes following maternal use of pregabalin.

Methods: This multicenter, observational prospective cohort study compared pregnancy outcomes in women exposed to pregabalin with those of matched controls (not exposed to any medications known to be teratogenic or to any antiepileptic drugs). Teratology Information Services systematically collected data between 2004 and 2013.

Results: Data were collected from 164 exposed pregnancies and 656 controls. A significantly higher major birth defect rate in the pregabalin group was observed after exclusion of chromosomal aberration syndromes, and when cases with exposure during first trimester of pregnancy were analyzed separately (7/116 [6.0%] vs 12/580 [2.1%]; odds ratio 3.0, 95% confidence interval 1.2–7.9, p = 0.03). The rate of live births was lower in the pregabalin group (71.9% vs 85.2%, p < 0.001), primarily due to a higher rate of both elective (9.8% vs 5.0%, p = 0.02) and medically indicated (5.5% vs 1.8%, p = 0.008) pregnancy terminations. In the Cox proportional cause specific hazards model, pregabalin exposure was not associated with a significantly higher risk of spontaneous abortion.

Conclusions: This study demonstrated a signal for increased risk of major birth defects after first trimester exposure to pregabalin. However, several limitations such as the small sample size, differences across groups in maternal conditions, and concomitant medication exposure exclude definitive conclusions, so these results call for confirmation through independent studies."

Still on the market...Why?

https://web.archive.org/web/20161029080541/https://www.neuro...

[stacktrust]

In theory, LLMs could review more sources for a personalized risk assessment. But a brief query on this subject yielded generic responses from multiple LLMs :(

[rpaddock]

I've seen AI recommended things like Fluoroquinolones (Avalox, Cipro, Levaquin etc), for UTIs.

The FDA itself says this class of drugs work no better than a placebo for UTIs, Sinusitis and Bronchitis. While they cause life altering side effects. They 'Flox' people.

My late wife's Journal was part of the evidence during a 2015 FDA hearing to get this crap off the market.

The bottom line is that AI can not be trusted for Medical Advice. Be highly suspicious of a Human doctor recommending a drug in this class, that has so many Black Box Warnings.