Physicians may consider prescribing Lyrica (pregabalin) for fibromyalgia patients who have a primary complaint of neuropathic pain, new research shows.
The study, titled “A comparison of the effectiveness of amitriptilin and pregabalin treatment in fibromyalgia patients,” was published in the journal Northern Clinics of Istanbul.
Fibromyalgia is often treated with non-standardized methods, such as the use of antidepressants, some of which have shown significant effectiveness. One such antidepressant is Elavil (amitriptyline).
Another drug that has shown efficacy in fibromyalgia treatment is Lyrica, marketed by Pfizer. Lyrica was the first drug to be approved by the U.S. Food and Drug Administration for fibromyalgia treatment. Because Lyrica acts independently of antiepileptics, antidepressants, or analgesics, it can be used safely with other drugs.
While there are several approved drugs for the treatment of fibromyalgia, no one pharmacological agent can completely resolve all the symptoms of the disease.
In the study, researchers set out to compare the effectiveness of two of these therapies: Elavil and Lyrica.
Researchers recruited 71 women with fibromyalgia and divided them into two groups. Thirty-six patients were treated with Lyrica at a dose of 450 mg, and 35 women were treated with Elavil at a dose of 25 mg.
After 12 weeks of treatment, the team assessed the patients’ condition through several tests, including the Fibromyalgia Impact Questionnaire, Fatigue Severity Scale, Modified Fatigue Impact Scale, Hospital Anxiety Depression Scale, Nottingham Health Profile, Mini Mental State Test, and the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS).
They also tested pain at all the tender points using a pressure algometer.
Results from the study showed that both drugs were able to improve pain, fatigue, sleep disorder, disability, psychological evaluation, and cognitive function. Elavil was found to be slightly more effective at decreasing pain; but this result was not significantly different between the two groups.
Interestingly, the study group included a number of patients who had neuropathic complaints, which are caused by damage to the nervous system and can result in dysesthesia, which are abnormal sensations, or in allodynia, which is pain from a normally nonpainful stimulus.
The LANSS test, used to assess neuropathic pain, showed that while that score improved significantly in both groups, there was a greater improvement in patients treated with Lyrica.
“We can say that neither drug is superior in terms of effectiveness on systemic symptoms of myalgia,” the team wrote. “However, we can state that amitriptyline [Elavil] is more effective in decreasing experimental pain, whereas pregabalin [Lyrica] is more effective in relieving neuropathic complaints.”
“According to these results, preference for pregabalin may be recommended in fibromyalgia patients whose primary complaint is neuropathic pain,” the team concluded.
