Less common anticonvulsants for neuropathic pain states
Gaba/lyrica/topamax are commonly used for neuropathic pain states, as well as antidepressants and topicals.
How about the other anticonvulsants? Does anyone try tegretol or any others before resigning these people to stim? (Source: Student Doctor Network)
Source: Student Doctor Network - August 4, 2017 Category: Universities & Medical Training Authors: Timeoutofmind Source Type: forums
NEJM: Increased RX of Gabapentin/Pregabalin Cause for Concern?
"Third, evidence suggests that some patients misuse, abuse, or divert gabapentin and pregabalin.5Some users describe euphoric effects, and patients can experience withdrawal when high doses are stopped abruptly. The likelihood of gabapentinoid abuse is reportedly heightened among current or past users of opioids and benzodiazepines. Whether misuse and abuse of gabapentinoids will become an important public...
NEJM: Increased RX of Gabapentin/Pregabalin Cause for Concern? (Source: Student Doctor Network)
Source: Student Doctor Network - August 3, 2017 Category: Universities & Medical Training Authors: drusso Source Type: forums
Determining "clinical significance" for Lyrica in Fibro: VAS goes from 6 to 5.6 after 14 weeks
Why is Lyrica considered "clinically significant" in pain control for Fibro when the studies they are quoting show a difference of VAS from 6 to 5.6 after 14 weeks?
Seems odd that a 4% benefit in score allows at 700/month prescription with many side effects is somehow clinically acceptable?
How does that work? (Source: Student Doctor Network)
Source: Student Doctor Network - May 10, 2017 Category: Universities & Medical Training Authors: DrCommonSense Source Type: forums
question...
Greetings.
What do you say to your patients, who arent really looking for opioids, but have side effects to gabapentin, lyrica, nortyptiline and cymbalta...
They do say that ibuprofen works, etc...
lets take chronic lumbar radicular pain not responsive to ESIs in a 64 year old patient as an example. lets say that the patient does not want surgery or SCS trial or "anything invasive" - which I personally understand also. a lot of my elderly patients are reluctant to this, and also do not...
question... (Source: Student Doctor Network)
Source: Student Doctor Network - April 21, 2017 Category: Universities & Medical Training Authors: neutro Source Type: forums
PHN refractory to conventional treatment
I saw a new patient in the office yesterday. 70 y/0 M with 1.5 years of severe pain secondary to a shingles outbreak in the left T5/T6 dermatomes. It doesn't appear that he received timely antiviral therapy at the time of outbreak and now he is suffering for it. He even asked to take off his shirt during the middle of the consultation secondary to pain. Prior to seeing me he has tried Hydrocodone, Gabapentin, Lyrica, Amitriptyline, Lidocaine ointment / patches, Calamine lotion and...
PHN refractory to conventional treatment (Source: Student Doctor Network)
Source: Student Doctor Network - March 30, 2017 Category: Universities & Medical Training Authors: EruditeDoc Source Type: forums
Pregabalin for Sciatica - NEJM
http://www.nejm.org/doi/full/10.1056/NEJMoa1614292?query=featured_home&
Trial of Pregabalin for Acute and Chronic Sciatica
Stephanie Mathieson, M.Chiro., Christopher G. Maher, Ph.D., Andrew J. McLachlan, Ph.D., Jane Latimer, Ph.D., Bart W. Koes, Ph.D., Mark J. Hancock, Ph.D., Ian Harris, Ph.D., Richard O. Day, M.B., B.S., M.D., Laurent Billot, M.Sc., M.Res., Justin Pik, M.B., B.S., Stephen Jan, Ph.D., and C.-W. Christine Lin, Ph.D.
N Engl J Med 2017;...
Pregabalin for Sciatica - NEJM (Source: Student Doctor Network)
Source: Student Doctor Network - March 29, 2017 Category: Universities & Medical Training Authors: oreosandsake Source Type: forums
Referral: Medicaid, Fibro, EDS, PTSD...
30 year old female on disability with 3 kids: OXY/APAP 10/325 four QD, Mobic 15 mg, Lyrica 300 mg BID, OTC Aleve, & Seroquel QHS.
What's your next move...
View attachment 215823 (Source: Student Doctor Network)
Source: Student Doctor Network - March 7, 2017 Category: Universities & Medical Training Authors: drusso Source Type: forums
ERX errors drive me crazy, share yours!
We must take the good with the bad. Here is the latest thing that drives me crazy about electronic prescriptions.
Lyrica 100 mg
1 c po qhs for 30 days
#90
The question is to type or not to type the 'for 30 days'? Does it mess up billing in any computer systems? (Source: Student Doctor Network)
Source: Student Doctor Network - January 11, 2017 Category: Universities & Medical Training Authors: FLPHARMD2001 Source Type: forums
Pain after laminotomy lead
Morbidly obese 59 yo patient s/p lumbar 4-5 and L5-S1 discectomy followed by two failed PLIF. Never fused. Was off of opioids prior to SCS trial. Had successful trial and was implanted with thoracic paddle lead by experienced neurosurgeon. Complaining of burning sensation and intermittent intense spasm in area of implant (paddle) since surgery. Surgeon prescribes hydromorphone and valium. Unsuccessfully trys: Neurontin, pregabalin, duloxetine, Lidoderm and compounded cream. Then, off...
Pain after laminotomy lead (Source: Student Doctor Network)
Source: Student Doctor Network - April 20, 2016 Category: Universities & Medical Training Authors: NJPAIN Source Type: forums
Anticonvulsant conversions
I have a satisfactory method to transition from Neurontin to Lyrica and visa versa from the psychiatry literature. However, I do not have a satisfactory way to transition from either Neurontin or Lyrica to other anticonvulsants such as Lamictal, Trileptal, etc. While an option is certainly discontinuing one prior to starting another that is obviously suboptimal in a patient with severe, poorly controlled neuropathic pain. Anyone willing to share their way to gradually transition or directly...
Anticonvulsant conversions (Source: Student Doctor Network)
Source: Student Doctor Network - February 24, 2016 Category: Universities & Medical Training Authors: NJPAIN Source Type: forums
Re: Pfizer steps up battle to defend control of pregabalin
(Source: BMJ Comments)
Source: BMJ Comments - July 7, 2015 Category: Journals (General) Source Type: forums
Re: Margaret McCartney: Second use patents—why do we have to prescribe branded Lyrica for pain?
(Source: BMJ Comments)
Source: BMJ Comments - June 9, 2015 Category: Journals (General) Source Type: forums
Re: Doctors are warned not to prescribe generic pregabalin for pain control
(Source: BMJ Comments)
Source: BMJ Comments - April 7, 2015 Category: Journals (General) Source Type: forums
