Meds & Supplements, Treatment

Lyrica Now Available to Patients

Pfizer announced today that Lyrica (pregabalin) is now available for doctors to prescribe to patients. The drug is indicated for use for neuropathic pain and seizures, but has also shown to improve patients’ sleep patterns. A successor to Neurontin (gabapentin), the two drugs act similarly in the body. Of course the chemical structure is slightly different (and beyond my understanding), but one obvious difference is that Lyrica is more potent, which makes it effective at lower doses. This in turn decreases the likelihood of side effects.

The FDA won’t let Pfizer mention this, but Lyrica, like Neurontin, is likely to be prescribed to headache patients off-label. And, based on a conversation with my headache specialist, it’s a potentially exciting new option for prevention.

Even with his endorsement, I’m a little skeptical. You see, the FDA has approved the manufacturing of gabapentin as a generic. Once the generic is available, sales of Neurontin, also a Pfizer drug, will drop. Lyrica could become to Neurontin like Clarinex is to Claritin.

It’s too soon to tell if Lyrica will be a significant new drug for headache patients or if it will another name-brand moneymaker. For all our sakes, I’ve got my fingers crossed for the first option.

Some interesting details about the drug are also available.

Meds & Supplements, Treatment

Antidepressants for Pain

“Why did my doctor prescribe an antidepressant? I’m not depressed, I have outrageous headaches!” I’m convinced that every headache sufferer asks this question at some point. If doctors don’t explain the reasons or if patients don’t understand them, we feel dismissed or as if our doctors didn’t listen to us.

But there are good reasons behind the drug choice. Some of the same brain chemicals are thought to be shared between the two diseases, so antidepressants can adjust the imbalance of migraine-related chemicals. Also, many antidepressants have pain-soothing properties.

Tricyclic antidepressants, including Elavil (amitriptyline), Tofranil (imipramine) and Pamelor (nortriptyline), have a long track record in treating pain. SSRIs, like Prozac, Effexor and Zoloft, don’t have as much proof supporting their efficacy for pain, but there is some evidence that they help reduce pain as well as treat other symptoms related to migraine, like anxiety.

Mayo Clinic provides an overview of why tricyclics are used for pain, how they work and side effects. The best description of SSRIs for headache that I’ve found is Headache 2005 from the Robbins Headache Clinic. Getting to it requires wading through a PDF, but it’s worthwhile. The SSRI information begins on page 32.

11/18/05: Turns out the chemical imbalance theory of depression is off-kilter. Antidepressants may work on the same areas of the brain affected by headache, but a chemical imbalance isn’t the place.

Meds & Supplements, Resources, Treatment

Weight Gain from Preventives

Weight gain is a common side effect of headache prevention meds and a patient can gain enough that the weight itself becomes health problem. Today’s NY Times article, Is Your Medicine Cabinet Making You Fat?, advises patients who gain weight while taking a new drug to talk with their doctors about changing meds or strategies to avoid gaining more weight. This rather obvious advice is supported by current medical research that has docs worried about the cumulative effects of weight gain.

WebMD provides a list of specific side effects for specific headache preventives. ACHE lists side effects by type of drug and guides patients on what they should talk to their docs about before beginning a new preventive.

Meds & Supplements, Treatment

Breastfeeding and Headache Meds

According to’s headache and migraine page, women who breastfeed can take some headache meds without exposing their babies to the drugs. The article outlines what precautions mothers should follow if they wish to take abortants or preventives while breastfeeding. Of course, women should consult with their doctors and choose their meds carefully.

Breastfeeding with Head Pain Disorders: What’s Safe, What’s Not and How to Find Out

Meds & Supplements, News & Research, Treatment

AHS’s Annual Meeting Underway

The American Headache Society’s 47th annual scientific meeting began today. Press releases are now available for some of the key conference presentations. There’s some good stuff here!

2/9/10: These press releases are no longer available from AHS.