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Dr. Bob is Robert Hsiung, MD,
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Posted by Cairo on February 24, 2006, at 15:32:38
Going to start Lyrica tonight for chronic pain. I developed tolerance with Neurontin and couldn't go too high on the dose due to side effects (not to mention decreased absorption with increasing dose). Had to increase, decrease, then stop and start all over again to reestablish effect. I was told today by a FMS research assistant that she's seen that happen in a couple of Lyrica patients in their FMS study. Should I expect tolerance to develop with Lyrica as it did with Neurontin or not? I know Lyrica has linear absorption.
Also, I'd like to get off clonazepam (0.5mg HS) for panic attacks that were induced (uncovered?) by a trial of Topamax. Any thoughts as to whether Lyrica will help with the panic attack symptoms (mostly physical now; going to ask to go back to propranol or pindolol from atenolol which my Internist switched me to because of "less side effects". Atenolol not as effective, though, for the sweats and nerves that are completely random.
Reasonable guesses appreciated.
Cairo
Posted by ed_uk on February 25, 2006, at 13:26:47
In reply to Re: Lyrica tolerance, posted by Cairo on February 24, 2006, at 15:32:38
Hi
>I developed tolerance with Neurontin and couldn't go too high on the dose due to side effects
What sort of side effects?
>Any thoughts as to whether Lyrica will help with the panic attack symptoms
It might do, it does appear to be mildly anxiolytic.
>I'd like to get off clonazepam (0.5mg HS) for panic attacks that were induced (uncovered?) by a trial of Topamax.
You could reduce the dose to 0.375mg for a week or two, then 0.25mg, then 0.125mg. If you have difficulty tapering with this schedule you could switch from clonazepam to an equivalent dose of diazepam - which is easier to taper. The 2mg diazepam tabs are particularly useful for tapering.
>atenolol
Atenolol is not effective for anxiety apart from the cardiac symptoms eg. chest discomfort, palpitations, racing heart etc. Propranolol can relieve tremor and other symptoms too. Have you actually tried pindolol previously? How did you find it? Comparable to propranolol in efficacy? What were the side effects which forced you to switch to atenolol?
Regards
Ed
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