If you are interested in this debate, you may be interested in this New York Times article that was published today:
Lyrica (pregabalin), the medication that is mentioned in this article, is a medication I've been researching for my psychotropic medication publication. This drug was first approved for use in the US in 2005, for the treatment of epilepsy, diabetic neuropathy pain and post-herpetic neuralgia. In 2007 it was also approved for treating fibromyalgia.
In addition, in my own research, I found publications describing 10 off-label (non-FDA approved)uses for this medication. One of these off-label uses, anxiety disorder, is actually an approved use in the European Union but not the United States. The references for these off-label uses, excerpted from my CD, are posted below.
Pregabalin is supposedly a more potent form of another popular medication, gabapentin (Neurontin). The use of this medication has been questioned, as at one point, it was estimated that 90% of its prescriptions were written for off-label uses. From what I could see when I was researching pregabalin, the trend with the newer version is not dissimilar.
From a biochemical standpoint, many of the off-label uses do make sense, as many of these issues have very similar biochemical origins. Off-label uses are not always inappropriate. However, it is important to make sure you know exactly WHY you are being prescribed a medication. You are entitled to ask your physician whether or not the medication you are being prescribed is FDA approved for your diagnosis, or if the use she is asking you to try is off-label. It's your body, and you have a right to make the most informed decision possible.
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Yokoyama T, Maeda Y, Audette KM, Sluka KA.Pregabalin reduces muscle and cutaneous hyperalgesia in two models of chronic muscle pain in rats. J Pain 007 May;8(5):422-9.
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Zesiewicz TA, Ward CL, Hauser RA, Salemi JL, Siraj S, Wilson MC, Sullivan KL. A pilot, double-blind, placebo-controlled trial of pregabalin (Lyrica) in the treatment of essential tremor. Mov Disord 2007 Jun 19.
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Rickels K, Pollack MH, Feltner DE, Lydiard RB, Zimbroff DL, Bielski RJ, Tobias K, Brock JD, Zornberg GL, Pande AC. Pregabalin for treatment of generalized anxiety disorder: a 4-week, multicenter, double-blind, placebo-controlled trial of pregabalin and alprazolam. Arch Gen Psychiatry 2005 Sep;62(9):1022-30.
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Kitchener JM. Glossopharyngeal neuralgia responding to pregabalin. Headache 2006 Sep;46(8):1307-8.
Hurley RW, Chatterjea D, Rose Feng M, Taylor CP, Hammond DL. Gabapentin and pregabalin can interact synergistically with naproxen to produce antihyperalgesia. Anesthesiology 2002 Nov;97(5):1263-73.
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Sommer M, Bachmann CG, Liebetanz KM, Schindehutte J, Tings T, Paulus W. Pregabalin in restless legs syndrome with and without neuropathic pain. Acta Neurol Scand 2007 May;115(5):347-50.
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Pande AC, Feltner DE, Jefferson JW, Davidson JR, Pollack M, Stein MB, Lydiard RB, Futterer R, Robinson P, Slomkowski M, DuBoff E, Phelps M, Janney CA, Werth JL. Efficacy of the novel anxiolytic pregabalin in social anxiety disorder: a placebo-controlled, multicenter study. J Clin Psychopharmacol 2004 Apr;23(2):141-9.
Muller JE, Koen L, Seedat S, Stein DJ. Social anxiety disorder : current treatment recommendations. CNS Drugs 2005;19(5):377-91.
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Davidson JR. Pharmacotherapy of social anxiety disorder: what does the evidence tell us? J Clin Psychiatry 2006;67 Suppl 12:20-6.
Davidson JR. Pharmacotherapy of social phobia. Acta Psychiatr Scand Suppl 2003;(417):65-71.
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