By Dr Ananya Mandal, MD
Fibromyalgia is one of the common causes of widespread pain and fatigue associated with other symptoms. Apart from the pain and fatigue there are symptoms of sleep disturbance, impaired physical functioning, altered mood and diminished or poorer health-related quality of life.
The exact cause of this condition is unknown but there are several studies that connect abnormal pain perceptions with fibromyalgia. The pain modulation pathways in the brain seem to be altered to make pain sensitivity heightened among these patients and in addition there are lowered pain thresholds.
Pregabalin is a medication that prevents the release of pronociceptive neurotransmitters or the chemical messengers of brain from the pre-synaptic membrane in the brain.
Pregabalin is a calcium channel alpha(2)delta-subunit ligand that has several properties including pain relief, relief from anxiety and reductions of symptoms in epilepsy patients.
Due to its ability to modulate the neurotransmitter release from the brain synapses, there may be benefits of this drug in fibromyalgia patients.
Pregabalin and fibromyalgia
Studies however have shown that at the approved dosages, oral pregabalin provides only a moderate benefit to the patients of fibromyalgia compared to dummy medications or placebo.
However, more than 30% pain relief has been seen with pregabalin in patients who responded favourably to the medication. Responders also showed pain relief lasting for at least 6 months on use. Longer studies are needed as most patients with fibromyalgia suffer for life.
Pregabalin treatment reduces the pain and also improves quality of life and overall health status among fibromyalgia patients by reducing pain, anxiety, fatigue and sleep quality.
The commonest side effects of use of this medication include dizziness, weight gain and increased sleepiness. These however are well tolerated by most patients. Pregabalin is thus considered an important medication that could be used widely among patients with fibromyalgia.
Pregabalin was the first FDA drug approved drug for the management of fibromyalgia. It could be taken at bed time and combined with either duloxetine or milnacipran on awakening in more effective management of symptoms of fibromyalgia.
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)
Last Updated: Sep 11, 2013