Lyrica(l) Depression

Pregabalin (Lyrica®) can significantly improve FM pain in people who also are being treated for depression, according to research presented at the American College of Rheumatology (ACR) Annual Meeting in San Diego. And my recent slow tapering off of Lyrica, and then returning to it (after way too much pain) confirmed this to me.

chronic comic 189I also suffer from depression. In fact, 50 to 70 per cent of people with FM report a lifetime history of depression, and approximately 25 per cent have a history of taking antidepressants.

Pregabalin is approved for the treatment of FM in the United States, Japan, Australia and other countries. But, because prior studies excluded the use of antidepressants in treatment, information about the effectiveness and safety of pregabalin for the treatment of pain in people with FM who are also being treated with antidepressants for their depression is lacking.

“Depression is common in patients with fibromyalgia,” explains Lesley M. Arnold, MD; professor of psychiatry and behavioral neuroscience; University of Cincinnati College of Medicine, Cincinnati, Ohio; and lead investigator in the study. “Many patients present to their doctor for treatment of fibromyalgia pain already taking antidepressants for their depression. This is the first study to evaluate the efficacy and safety of pregabalin for treatment of fibromyalgia pain in patients who are also taking antidepressants for depression.”

288. rate your painWith this in mind, researchers completed a study to determine if pregabalin would affect pain levels in people with FM who were also being treated for depression. The study included 197 patients who were, on average, 50 years of age and overwhelmingly white females. To join the study, patients had to meet the 1990 ACR Criteria (including manual tender point exam), have an average pain level of at least four out of 10 on the Numeric Rating Scale, (0 = no pain and 10 = worst possible pain), have a documented diagnosis of depression and be taking a stable dose of an antidepressant medication — either a selective serotonin reuptake inhibitor (such as Celexa®, Lexapro®, Prozac®, Paxil® or Zoloft®) or a serotonin-norepinephrine reuptake inhibitor (such as Cymbalta®, Effexor®, or Pristiq®). The antidepressant treatment was continued throughout the study.

Patients were on study treatment for a total of 14 weeks. There were two six-week treatment periods when patients received either pregabalin or placebo, with a two-week break in between these periods. Each patient was randomly assigned to receive either pregabalin in the first six weeks, then placebo in the last six weeks, or to receive placebo first, then pregabalin. None of the patients knew which treatment they were receiving at any point in the study. Pregabalin was started at a dose of 150mg per day, and increased to 300-450mg per day, based on each patient’s response; this dose was continued for the rest of the treatment period.

Chronic Comic 157At the beginning of the study, the average pain score amongst participants was 6.7. The average pain score dropped to 4.84 after treatment with pregabalin and to 5.45 after treatment with placebo. Pregabalin treatment significantly improved patients’ pain compared to placebo.

Side effects were reported in 77.3 per cent of those on pregabalin and 59.9 per cent of those on placebo. For pregabalin treatment the most common events were dizziness (28.2 per cent) and drowsiness (19.9 per cent). A total of four serious adverse events were reported; however, the researchers concluded these events were not related to the treatment.

“The results of this study demonstrate that pregabalin is safe and effective in reducing fibromyalgia pain in patients who are also taking an antidepressant to treat their depression,” says Dr Arnold.

Time is of the Essence

“Next Tuesday, we’re going shopping,” says my Mommy.

Monday arrives and I haven’t forgotten that we are going shopping on Monday; I just haven’t realised that it IS Monday.

One of my big problems is keeping track of time, especially dates. Birthdays and special events creep up on me and catch me unprepared all the time. I know when things are supposed to happen. I hear when some-one tells me about something. I also know how long it is supposed to take me to get ready to leave the house – I really hate being late, but I can’t seem to get a handle on this particular issue.

Like Adrienne Dellwo has said:

The farther out something is planned, the worse it seems to be. It’s like my brain files it under the heading “months away” and then never updates it to “next week.” If something is set for tomorrow or a week from Thursday, I do pretty well. Those things apparently go into the “really soon” file and stay more on the radar.

There’s a learning disability called dyscalculia – a learning disability that deals with math. It is similar to dysphasia, which includes those word-finding difficulties so many of us have. Dyscalculia not only impairs math and number abilities (forgetting concepts, transposing numbers), it also involves:

  • Difficulties with time: inability to remember schedules, keep track of time, or remember a sequence of events.
  • Spacial problems: impaired direction sense and memory of how things are laid out, leading to frequently getting lost or becoming disoriented.
  • Difficulty sight-reading music or learning instrument fingerings.
  • Inability to remember names.

72. manufacturers warrantyResearch shows that dyscalculia involves dysfunction in a specific part of the brain – all of the above problems stem from the same cause. It means that this is ONE problem only; and not a whole lot of unrelated issues being attributed to FM.

This doesn’t necessarily make me feel better after being at the casino last week and not being able to work out the action on the Craps table (I was a Craps dealer/supervisor for 14 years!)

Dyscalculia can occur as the result of some types of brain injury, in which case the proper term is acalculia (or Acquired Dyscalculia), to distinguish it from dyscalculia which is of innate, genetic or developmental origin.

Dyscalculia isn’t something you can take a pill for – it’s something you have to live with. Scientists have yet to understand the causes of dyscalculia. 119-fibro-fogThey have been investigating in several domains including short-term memory being disturbed or reduced, making it difficult to remember calculations (Does this sound like Fibro Fog to you?) I haven’t found any scientific research that says that FM causes Dyscalculia (if you do, please share it with all of us!) but it certainly makes it worse.

The good news(?) is that it is a recognised learning disability, just like dyslexia or dysphasia. If it causes problems for you at work/school, you can talk to your boss/teacher about having this learning disability without having to disclose that you have FM, or trying to explain brain fog.

Sex, Pain and Fibromyalgia

Whether we know it or not, every day we weigh up the pros and cons of doing our every-day activities: if I vacuum the house now, will I have enough energy later to prepare dinner? Is it worth the pain I am going to feel tomorrow to go to that party tonight? Do I really need to go to the supermarket today or is there something in the freezer? Every day, our heads do these calculations just so we can make it to the next day…

Here’s one that only you guys are going to understand…remember the guy that I was banned from seeing? (Yes, it was quite a long time ago) The mutual ‘friend’ who did the banning hasn’t spoken to either of us since then, so we decided we should keep in contact.

pin up 4Long story, short: after 5 months of umm-ing and ah-ing, I had sex!!!

It had been a rather long time between drinks so there was lots of preparations to do: clean the house, change my sheets, prepare supper, waxing, hair-cut, etc, etc. I couldn’t eat anything all day as I have been struggling with major IBS issues and we really wouldn’t want THAT happening!

He had warned me prior that it had been a while for him, too, so there would probably be a need for (at least!) a second act.

Without going into too much detail:

ACT ONE

Candy Shop……….chorus
https://www.youtube.com/watch?v=SRcnnId15BA&w=500

Fever……….FibroModem
https://www.youtube.com/watch?v=IP0VpKCaGvM&w=500

Crazy………..Him
https://www.youtube.com/watch?v=IP0VpKCaGvM94&w=500

Pump It……….FibroModem and Him
https://www.youtube.com/watch?v=ZaI2IlHwmgQ&w=500

Not Fair……….FibroModem
https://www.youtube.com/watch?v=JbeMw7D2Y7Y&w=500

domAnd with that, he fell asleep…and not a light sleep! I let him rest for an hour then tried to wake him up: a light touch, kissing, tickling, pull the blankets off – I even grabbed a gag gift (cat’o’nine tails) and whipped his butt…he didn’t move!

Talk about disappointment!

And then came the consequences…the next day began with me waking with the inevitable head and face ache. I tried to move from my bed and my skin hurt. I landed on my feet which, once again, felt swollen and broken despite there being no visible problem. My stomach and chest was cramping so I lay on my couch with a heat pack all day.

So weighing up the pros and cons, was it worth it?