#pregabalin

[queerautism]

hot take but: no one forced you to start the pregabalin in the first place

No, of course. I could have told the doctor I didn't want to take the only thing they were willing to prescribe for my chronic pain and accepted that all investigations into it would also stop.

Before pregabalin, they put me on gabapentin, which I had to stop pretty quickly because it made my (usually very background, passive) suicidal ideation Extremely bad. I was also not warned about any potential side effects for gabapentin, and in fact wouldn't have even known this was a possible side effect if it wasn't for some other chronically ill people that talked to me about it, and enabled me to recognise it.

Any chronic pain patient knows how easily and how strongly doctors push these two medications onto us. Often without any discussion of possible side effects and how hard it can be to get off them. I've seen people say similar things about cymbalta / duloxetine as well.

Anyway, my entire point is that patients deserve the chance to give informed consent to medications - And this needs to involve an actual discussion of common side effects, what it is like to stop taking it, etc.

[h4vemercy]

Chronic pain but make it coquette

[clonazepamcuti3]

300mg gabapentin every half hour with a fizzy drink & fatty foods

only the gaba goddess’s get it.

[thechronicpaingame]

Back at it again with the pregabalin. Turns out, it was helping! 😂 I honestly thought it wasn't having any effect but I have seen the light on how much worse things can be.

[potsiefaerie]

Hey! If youre omay with it. Could you explain how myoclonus affects you and how you got it diagnosed? Is there anything that can be done to help it?

Oh sure!

So the type I have is probably action myoclonus but the official diagnosis is just "idiopathic myoclonus" aka "I don't fucking know why your body is doing this"

For me it's usually like big jerks in my arms/legs, particularly if my presyncope gets really bad, sort of like a little prequel to convulsive syncope.

I also get it when I'm just really exhausted, I'll try to use a muscle to lift something heavier than my phone and my muscles will just freak out and I sometimes end up dropping or tossing whatever I was trying to pick up.

I got diagnosed by inducing an attack in a neurologist's office - I could feel I was beginning to faint and I held my breath and picked up my full waterbottle I think and BAM, arm flail, nearly fell out of chair, and the doctor went "OH." and said she'd talk to some of her colleagues. She came back and said it was definitely myoclonus (which is what I'd figured from watching videos online), and suggested we try a medication - pregabalin.

It causes drowsiness but I take it at night, and it doesn't seem to exacerbate any of my other conditions or interact poorly with any of my other meds. It makes the attacks less frequent and less severe. It's also sometimes used as a fibromyalgia treatment as well, and it seems to have lowered my chronic pain some too.

[mari3452]

Czy jestem uzależniona?

Ostatni raz brałam tamtego lata

Gdy była zima radziłam sobie z głodem dobrze, ale.. gdy nastało lato zaczęłam mieć większy głód

Trzęse się cała, zimno mi i mam ciarki, czuję spięcie w całym ciele i mam ogromną chęć coś wciągnąć..

Biorę pregabaline żeby nie czuć tego.. 900mg a to już jest dawka po przedawkowaniu, wtedy nie odczuwam głodu i tylko lekko się trzęsę i od czasu do czasu mam chęć coś wciągnąć, ale przy lekach sobie radzę z tym

Możliwe, że radząc sobie z jednym wchodzę w drugie, ale nie wiem sama co o tym myśleć..

Może ktoś mi pomóc się dowiedzieć czy to jest już uzależnienie...?

[nomorelostyears]

I did it again

OD playlist coming soon

[paragwajskaalpaka]

all memories = wasted all i want = busted

[lelibug]

Sensory Overload Vs BlackOuts

BLOG | Sensory Overload Vs BlackOuts | delphinemusic Blacking Out Constantly... And starting to realise Sensory OVerload is a BIG Trigger, I think... #Fibromyalgia #ChronicPain #chronicillness #sensoryoverload #Autistic #NorthWales

The Sensory Overload From It Is STILL Affecting Me Now… Having More BlackOut “Episodes” than usual at this time [of day]. Went out for the first time in maybe 6 months… Didn’t even feel like it had been Six Months since I’d done so… Felt like riding a bike, strangely enough. Yesterday, I went shopping for the first time in…. A Year? I didn’t even realise that, until I got home. It was only…

[roboticchibitan]

PSA for people who take Lyrica (pregabalin)

If you take Lyrica for chronic pain, (or probably any other reason, but that’s why I take it and that’s what this post is about because this is the extent of my scope), and you smoke weed, you should know that weed can cause the Lyrica to become ineffective.

I started taking Lyrica a few days ago, and I noticed a big difference almost immediately, but I was on edge yesterday and kinda nauseous so I smoked weed and within about 30 minutes I was hurting so bad. So I looked it up and found this study that found drug ineffectiveness was a possible drug interaction between the two. If you take both though, don’t freak out. This study was done only on individuals who reported side effects. So there’s no data about how prevalent this interaction is in general. But of the 298 people who DID have side effects, 147 of them reported drug ineffectiveness. That’s almost half of the people who reported side effects. So while the study has flaws, and we don’t know how common this is in everyone who takes Lyrica and smokes weed, it’s worth noting that this is a known interaction that the common interaction checkers overlook.

[mcatmemoranda]

Pregabalin is a controlled substance, but I never see if when I check PDMP. I didn't understand why it's a controlled substance, but it is.

Lyrica (pregabalin) is a Schedule V (Schedule 5) controlled substance, the lowest schedule for abuse potential, as defined by the Drug Enforcement Agency (DEA).

No, it is not a narcotic (opioid), but is used to treat various types of nerve pain (diabetic neuropathy, herpes zoster), as well as epilepsy, fibromyalgia and spinal cord injury.

Both Lyrica and Lyrica CR are classified as schedule V controlled substances because of reports of euphoria, improved happiness, excitement, or calmness, and a "high" similar to marijuana with use of pregabalin.

In general, medications in schedule V are considered to have a low potential for abuse compared to medicines in other schedules I-IV. Medicines in Schedule V are most commonly used to treat diarrhea, cough or mild pain. Certain anticonvulsants and antimigraine agents are also found in Schedule V.

[nixmcretro]

Me, Myself and Progesterone

I touched on progesterone (P4) in my last transgender update post. I am not quite sure if progesterone is working in the way I want it to. My biggest annoyance with it is feeling like my brain is on fire just before trying to sleep.

Rewind to late February 2024, for almost three weeks my progesterone dose was doubled to 400 mg of oral, micronised, compounded progesterone – 200 mg twice a day. That’s up from the 200 mg once at night.

I had also ceased finasteride. And finasteride interferes with the progesterone (oral) pathway conversion to neurosteroids such as allopregnanolone. This is because finasteride blocks *most* of the activity (~70%) of the 5-alpha reductase (5AR) enzyme. In turn, reducing levels of allopregnanolone – or at least slowing their conversion to neurosteroids.

My sleep quality has been pretty broken for a while now. Look at those orange blocks. And here I was looking forward to some of the benefits from progesterone. Anxiolytic? Yes please! Sleep improving? Definitely!

Instead I get this whole brain fire thing and feel like I’ve taken an anxiogenic. That got me thinking, brain on fire? Throw in some formication and it’s what feels like a glutamate rebound or surge. Excitotoxicity perhaps?

I’ve experienced similar feelings while withdrawing from pregabalin (decreases glutamate levels) and trusty old diazepam (increases GABA levels). Definitely that same feeling though. It appears that taking what I would consider a small dose (2 mg) of diazepam negates the insomnia pretty well. Even though diazepam isn’t a terribly good choice for sleep. It takes me from being a wired insomniac to sleeping beauty in about an hour.

Another interesting side effect I am seeing a lot more of is dissociation. Ordinarily, I would only experience this while in high stress, high anxiety situations but recently I’m noting it a lot more just doing chores around the house – which is a little concerning.

Regardless, it seems that something is messing with my GABAergic system and metabolites of progesterone fit the bill. Armed with my two-thirds of a biomedical science degree I went digging for more information on the metabolites. Up above is an image from my last health blog post. Note the action of finasteride on progesterone – blocking allopregnanolone (THP) and isopregnanolone.

I wonder if moving to a more potent 5AR blocker, such as dutasteride, would reduce the side effects of a higher dose of progesterone? A question for my endocrinologist I suppose. I restarted my finasteride to at least partially block some of the following progesterone metabolites. Let’s look at the metabolites a little closer and how they act.

Allopregnanolone (Tetrahydroprogesterone or THP) Positive allosteric modulator 9 hours

Pregnanolone Positive allosteric modulator 1 – 3.5 hours

Isopregnanolone Negative allosteric modulator 14 hours Targets allopregnanolone only

Epipregnanolone Negative allosteric modulator Half-life unknown

Alright, so a bunch of neurosteroids are doing a bunch of things. A few are being blocked, but also produce negative side effects when they weren’t blocked. Hormones are messy. Where does that leave me? I guess I am left questioning whether I should be taking progesterone at all. At minimum a dose reduction is definitely called for. I will probably return back to 200 mg and see what symptoms, if any, follow.

My search revealed some interesting data with overlap in symptoms shared with premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) in cisgender women. 

PMDD is believed to be caused by fluctuations in gonadal sex hormones or variations in sensitivity to sex hormones.

If sensitivity to level shifts is reason for the negative side effects, then single or even twice daily doses are probably not enough to smooth out the levels of neurosteroids for me, allowing me enter a withdrawal state, perhaps? Brain on fire? This paper offers some great insight into the mechanisms behind it all with some interesting side notes on SSRIs.

Interestingly, SSRIs increase allopregnanolone levels in the brain, rapidly and at low doses, as demonstrated in rodents as well as in patients with depression.

Could this be one of the reasons why I can’t tolerate SSRI/SNRIs? At the very least, it’s some food for thought. Worth noting that the original study has been questioned a little further along in the paper. Let’s circle back to those progesterone levels again. From Wikipedia

Progesterone levels tend to be less than 2 ng/mL prior to ovulation and greater than 5 ng/mL after ovulation.

What were my most recent levels again? 9.1 nmol/L or should I say 2.6 ng/mL (freedom units). That’s at 200 mg once daily at night, measured in the trough. I really need to ask myself, do I want to have symptoms of PMS/PMDD? Is that even a question that needs to be asked?

Looking at the levels on Table 1 in this paper give an idea where my levels line up. If you factor in the short half-life of most of the metabolites, once daily dosing is probably a bad idea. Ideally, I should look into getting the dose split to 100 mg twice daily.

Of course I have to be mindful of negative risk such as the androgen backdoor pathway. This has the potential to generate unwanted androgens like DHT – which will affect the hair on my head. That’s why the finasteride is here to stay until most means of testosterone generation is removed from my system…

It’s not all bad though. Finasteride competes with progesterone for the 5AR enzyme – which results in even less 5AR being available for testosterone -> DHT conversion. Another point worth considering is that progesterone has a positive effect on bone-building cells (osteoblasts). This can help with avoiding or reducing effects of osteoporosis.

Touching on side effects I’ve noticed, Progesterone should increase libido. Which is something I do not want due to past trauma. However, I wonder if the finasteride side effects are at play here. Again, I don’t consider them negative side effects either.

Other oddities I’ve also noticed my facial hair has become darker at the higher progesterone dosing at 400 mg. My upper lip now has dark black hairs, that’s new and unwanted. It might be useful for IPL treatment. But now there’s shadow on my upper lip I never had before. It isn’t just the thinning of skin either. The hairs are black instead of blonde.

One big uncertainty is that I’m not sure what my levels of estradiol will be at the next blood test. Are the 200 mg of pellets doing their job properly? Or did they fail? Does the dose need to be increased?

For now, I’ve been supplementing the implant with the remainder of my 2 mg estradiol pills while the pellets stabilise. One pill gives me ~85 pmol/L in estradiol levels. I’ve only just ran out of those so now I’m adding in some of the estradiol gel (Sandrena branded). These gave ~200 pmol/L estradiol per dose according to my most recent blood tests. In theory with one a day, I should be guaranteed to be in the late follicular phase – regardless of the implant levels.

Anyway, that was one heck of an info dump. I think that sums everything up that has been on my mind lately.

TL;DR 400 mg oral progesterone makes my brain go on fire. Progesterone metabolite levels shifting around are very activating for me. I will now target cisgender progesterone levels in the late follicular phase. Hormones are complicated. One size fits most seems to be at play when it comes to progesterone. Nothing like some trial and error! 🙃

[brujademente]

Im using pregabalin as a treatment for my hernia and nobody told me that, apparently, it could give me tachycardia so now I'm laying down with my heart going nuts, feeling fucking weird and a very painful leg and it sucks

[thechronicpaingame]

I've been having so many issues recently with getting my pregabalin that I've just stopped it. So currently in a world of withdrawal 🙃 (I never felt any positive effects from it its just been the withdrawal I've been avoiding but CBA the stress of trying to get it every month). Think I only have a day or two of acute withdrawal left. Today's been rough but nowhere near as bad as when I stopped my tramadol (temporarily). So I'll check back in a few days!

(still having nightly fevers as well 😂 - I have just learnt to live with this now until someone decides to look into it more).

[brokenminds515]