Pregabalin for fibromyalgia: Some relief but no cure

Abstract

What is the role of pregabalin (Lyrica) in the treatment of fibromyalgia? In this article the authors explore the putative pathophysiology of fibromyalgia, pregabalin's mechanism of action and evidence of efficacy, and its emerging role in treating this challenging disease.

Attenuation of reserpine‑induced fibromyalgia via ROS and serotonergic pathway modulation by fisetin, a plant flavonoid polyphenol

“…A previous study demonstrated that pregabalin inhibited the release of NE and substance P via binding with the α-2-Δ subunit of voltage-gated presynaptic calcium channels to exert beneficial effects in FM symptoms (73). However, pregabalin produces only partial relief and does not cure FM (74). In the past few decades, medicines of herbal origin, including Rhizoma drynariae (75) and Baishao zongdai (68), demonstrated significant efficacy in terms of safety in the management of FM.…”

Liquid chromatography atmospheric pressure chemical ionization tandem mass spectrometry method for the quantification of pregabalin in human plasma

“…1), is a novel analogue of the neurotransmitter gamma amino butyric acid (GABA) with analgesic, anticonsulvant and anxiolytic activity. Pregabalin (Lyrica ® ) has been approved in 2007 by the US Food and Drug Administration (FDA) as the first drug for the treatment of fibromyalgia [1]. Pregabalin has been approved earlier by the FDA for the treatment of neuropathic pain and as an adjunctive therapy for refractory partial seizures [2][3][4][5].…”

Effect of pregabalin on post-dural-puncture headache following spinal anesthesia and lumbar puncture

“…[31][32][33][34] The efficacy of these 2 compounds for the treatment of chronic pain has also been shown in clinical studies of diabetic and chemotherapy-induced neuropathic pain, postherpetic neuralgia, fibromyalgia and postoperative pain. 16,[18][19][20][21][22]31 In light of these observations, we hypothesize that alpha 2 -delta type voltage-dependent calcium channels mediate the effect of pregabalin on PDPH pain. Although pregabalin is chemically similar to c-aminobutyric acid (GABA), it is currently accepted that the activity of pregabalin does not include GABAergic mechanisms.…”

“…14 Pregabalin, a ligand of the alpha 2 -delta type voltage-dependent calcium channels, reduces calcium influx at the nerve terminals and attenuates the release of glutamate, substance P and norepinephrine at the synapses. [15][16][17] Alpha 2 -delta type voltage-dependent calcium channels have recently become a treatment target for some chronic pain conditions. The efficacy of pregabalin as an analgesic agent has been shown in many clinical studies.…”