Dear Mari

Neither gabapentin nor pregabalin (Lyrica) are approved for depression or treatment of moodswings. Use in this regard varies in success from patient to patient... some may have benefits. Many patients have no mood changes (in terms of mania or depression) whatsoever from gabapentin.

Unlike gabapentin, however, pregabalin (Lyrica) is approved for the treatment of GAD in the EU.

http://en.wikipedia.org/wiki/Pregabalin#Uses
It is possible that the anti-depressive effect you experience from gabapentin is an indirect effect of its anxiolytic effect. if that is the case, you should experience the same benefit with Lyrica.

-----------------------

Lyrica has very different pharmacokinetics in the way of absorption... it is absorbed faster (peaks in an hour as opposed to 3-4). Lyrica also has a more predictable dose-effect relationship.

A comparison of the pharmacokinetics and pharmacodynamics of pregabalin and gabapentin.
from: Clinical Pharmacokinetics 2010 Oct;49(10):661-9.
authors: Bockbrader HN, Wesche D, Miller R, Chapel S, Janiczek N, Burger P.
Pfizer Global Research & Development, Ann Arbor, Michigan 48105, USA.
Did you discuss your prior issues with raising gabapentin with your doc?
Did your doc suggest raising the gabapentin to 600mg before switching?

If not, i would give her a call and discuss these things.... it might be better to just switch, especially if you can start low and titrate with the Lyrica.

I wouldn't want you to give up on Lyrica before even starting.

I hope you are able to try it it works out well for you!

~ waves ~ the worrywart

Waves,

I appreciate this. I will get back to to your post later.

For now:
I did discuss prior problems with raising Gabapentin dose.

Pdoc said that at 400-600 people can experience relief of nerve pain on Gabapentin. He wrote the script for 600 mgs per day (6 x 100mg capsules. He told me I have the option to move up to 300 if I am comfortable.

Mdoc is beginning to understand my concerns about starting at low doses. She did not have samples but gave me a coupon for a year's worth of Lyrica at a low (-ish) dose but the coupon is a hassle and I have not dealt with it. Work is intense right now. I do not know how big the Lyrica dose is. (She and I communicated well in this visit compared to other visits but missed the dose part of the Lyrica talk and have not looked on line or at my coupon packet.

Two days in a row I took 300 mgs plus half of a 100 mgs capsule.
I want to try the 600 dose to see if it helps before I try Lyrica.
It is good to have options.

I do not want to call her. I plan to make an appointment soon with the her -- maybe 4-5 weeks -- by then she will have the blood work results if I make the lab appointment soon. And I can report on the Gabapentin and /or the Lyrica.
She forgot to tell me to tell me when to come back to see her but she sent me for a TON of blood work.

I recognized that after a gap of a year and a half between appointments, it took her a long time to go over my file with me. She is still looking for the cause of the stroke and maybe some other things. I reminded her of stuff she recollected but did not immediately come acorss in the paper file.
(I can look at the paperwork for the lab to see what it is she is looking for but not have done that yet.)
She did decide that perhaps the birth control pill caused the stroke and told me not to ever take any of those kinds of hormones in the future.

M

What do you think about the pill causing your stroke? I guess I thought it was from not using your CPAP?????
bizi

Sleep doc could not say either way that not wearing the mask caused it. He was all mumbly about, saying something like, "I can't say it did not cause it but I cannot say that it did.

The pill could be the cause. I had already thought of it at the time and took myself off the pill when I was in the hospital.

M

thank you for sharing.I think my mother got blood clots in her lungs from the pill and almost died. There are risks in every thing that we take.
I h ope that I don't get tarditive dyskenisia.....
bizi

I am on the pill and worry about this strokes, blood clots, too. But I have PCOS and the pill keeps the cysts on my ovaries from growing so I take it. I've already had 1 laproscopic surgery to remove a cyst that got too large and I don't want another surgery. My grandmother has tardive dyskenisia and I hope I never get that either. As if we didn't have enough to worry about already... I get these thoughts but I try to push them out of my head. What's the alternative, go off my meds and lose my sanity? No thanks.

i choose sanity any day!
bizi

Hi, Bizi and Butterfly,

Do not not let my post above concern you. I was just rattling on about how the mdoc is still searching for answers.

I was on the birth control pill 1) partly for something else and 2) partly for mood swings.
The pill worked well for ten years.
I do not know if my internist knows what she is talking about. She is not an expert on the pill or about strokes.

M