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Microsoft word - documentDear Dr. Kat, I keep hearing about Lyrica® on TV for fibromyalgia, and I wanted to know more about it. Cynthia Dear Cynthia, Television is flooded with drug advertisements with Lyrica being at the forefront. It’s one of the only drugs FDA approved for fibromyalgia (Gabapentin and a few others are used off-label). The ads are good at persuading people to call their doctors for a prescription but they fail to mention a lot of important information that the consumer may need to know before determining if the drug is right for them. Of course, it would take much longer than 30 to 60 seconds to perform such a feat. It’s always a good idea to ask your doctor or pharmacist about any medication that you feel might be good to take before using it. Lyrica® is FDA approved for certain neuropathies and for Fibromyalgia. Dosages vary according to the condition that’s being treated. A recommended initial dose for Fibromyalgia is usually 75mg taken twice a day (total of 150mg per day) with a maintenance dose between 300 to 450mg per day. Doses over 600mg per day have not shown a lot of benefit while also increasing the incidence of side effects. Of course, most people want to know if there are any nasty side effects, and Lyrica® along with many other drugs does not disappoint. The most common include weight gain, blurred vision, impaired thinking mainly with concentration and attention, dizziness, dry mouth, edema, and somnolence (sleepiness). Of those mentioned, dizziness and somnolence were listed as the most common reason for stopping the drug. In one study, about 30% experienced dizziness and a little over 20% experienced somnolence. It’s important to know how Lyrica® my affect you before driving a car or operating any other heavy machinery. Also, avoid alcohol consumption while taking Lyrica® as well since it does work on the central nervous system. Weight gain reported was not just due to edema, and diabetics were noted to have a higher weight gain than others. Also, diabetics taking Lyrica® with a thiazolidinedione antidiabetic drug showed a higher prevalence for weight gain and edema. Even though there’s not much data available as to an increased chance for heart failure, it’s important to use Lyrica® cautiously in those who are also taking this type of antidiabetic drug. Diabetics need to check your skin on a regular basis as skin ulcerations have occurred while using this drug. Another point to emphasize is to gradually come off Lyrica® over at least a one week period. Abruptly stopping Lyrica® can lead to headaches, nausea, diarrhea and insomnia. However, in people who experience seizures, the abrupt withdrawal of Lyrica® may precipitate a seizure. In a nutshell, if wanting to stop Lyrica® for any reason, speak with your doctor for a taper schedule. Don’t do this on your own. The mention of cancer I know will strike fear in some, but I would be remiss for not mentioning a possible tumorigenic potential while taking Lyrica®. There was a high incidence of tumors found in mice while testing Lyrica®, and roughly 57 people showed new or worsening of pre-existing tumors while taking Lyrica® in clinical trials, but it’s still inconclusive as to the potential of Lyrica® to cause tumors to form. However, this is something to discuss with your physician before taking especially if you have a past history of cancer. In addition, if you notice any changes in mood or behavior such as feeling bluer than normal, please contact your doctor. Lyrica® may cause depression or suicidal thoughts in certain individuals. People with kidney dysfunction may need the dose adjusted, and your kidney function maybe monitored for this reason. If you are pregnant, plan to become pregnant or are breast feeding, please contact your doctor to discuss concerns regarding this drug. Men’s fertility may also be affected. So, please contact your doctor for any questions. There are a lot of side effects not mentioned in the article, but if you notice anything unusual, don’t be afraid to ask your pharmacist or doctor about it. I know that I’ve experienced rare side effects before. It’s better to get it documented than to be miserable or have something worse happen to you or your loved ones. Fibromyalgia is a difficult syndrome to diagnose and treat. Unfortunately, there aren’t many drugs available that are specifically for Fibromyalgia. Lyrica® may work for you, but speak with your doctor before just asking for a presciption. If you or a loved one have a question about a drug, please e-mail me at email@example.com.
CHRONIC NON-BACTERIAL PROSTATITIS AND THERMAL THERAPY LITERATURE Third International Chronic Prostatitis Network Transrectal thermotherapy of chronic prostatitis H. Ljungnér Assistant Professor and Private Practitioner, Halmstad Sweden Transrectal thermotherapy (TRT) is an effective way to improve prostatitis of a chronic nature. Its mode of action is not clear b