Lyrica May Ease Pain for Depressed Fibromyalgia Patients

Study finds drug safe, effective in combination with antidepressants

By Kathleen Doheny

HealthDay Reporter

MONDAY, Oct. 28 (HealthDay News) -- Fibromyalgia and depression often go hand in hand, and a new study finds that the drug Lyrica helps ease pain in patients being treated for both conditions.

Lyrica (pregabalin) is approved in the United States to treat fibromyalgia and nerve pain from diabetes and herpes, but little was known about its safety and effectiveness when also taken with antidepressants, the researchers explained.

"For those people with fibromyalgia who also have depression, which is very common, and who take an antidepressant but still have pain, taking [Lyrica] can reduce the severity of the pain while they continue on their antidepressant," said study author Dr. Lesley Arnold, professor of psychiatry and behavioral neuroscience at the University of Cincinnati College of Medicine.

"And it appears to be safe and tolerable for most people," Arnold added.

Arnold is scheduled to present the findings this week at the American College of Rheumatology annual meeting in San Diego. She is a consultant for Pfizer, the maker of Lyrica, and other pharmaceutical companies, including Takeda, Eli Lilly, AstraZeneca and others.

Fibromyalgia is a long-term syndrome that involves pain at different points throughout the body and tenderness in the joints, muscles, tendons and other soft tissues. The syndrome has been linked to fatigue, sleep problems, anxiety and depression, but its cause is unknown. Women aged 20 to 50 are most often affected.

The new study was done because the original research on Lyrica for fibromyalgia indications excluded people taking antidepressants, Arnold said. About 50 percent to 70 percent of those with fibromyalgia report a lifetime history of depression, and about one in four has taken antidepressants, Arnold said said.

For the new study, Arnold's team evaluated 197 patients, mostly women, with diagnosed fibromyalgia. Their average pain level was at least four on a scale of zero to 10, with 10 being the worst. All also had clinical depression and were taking antidepressants. Their average age was 50.

The researchers randomly assigned the patients to two six-week treatments, with a two-week break in between. Patients either got Lyrica or placebo the first six weeks, then received the other treatment for the next six-week period. They didn't know which treatment they were getting.

Lyrica was started at a dose of 150 milligrams (mg) a day and increased to 300 mg to 450 mg, based on response.

At the start, the average pain score was 6.7 of 10. After taking Lyrica, the pain score dropped to 4.84 and after taking the placebo it fell to 5.45. The drug worked better than placebo. "It was a noticeable improvement in pain," Arnold said.

Side effects with the drug included dizziness and drowsiness, Arnold said. Four serious adverse effects occurred but were unrelated to the drug, she said.

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A Blood Test for Fibromyalgia?

Oct. 28, 2013 -- A new blood test may predict fibromyalgia, a condition that can be hard to diagnose.

Research about the new test was presented Sunday at the annual meeting of the American College of Rheumatology in San Diego.

EpicGenetics of Santa Monica, Calif., developed the test, called the FM/a test, says Bruce Gillis, MD, MPH. Gillis is the company’s CEO and an assistant professor of medicine and emergency medicine at the University of Illinois College of Medicine.

"It is objective, very accurate, and definitive," he says.

But the test’s high price tag -- $744 -- may keep its use limited for now, one expert says.

"Due to the cost and my lack of experience with this new test, I would initially use it in patients in whom I suspect as having fibromyalgia but lack some of the classic features, making the diagnosis more difficult," says Scott Zashin. Zashin is a clinical professor of medicine at the University of Texas Southwestern Medical School, Dallas.

Fibromyalgia causes widespread pain, tenderness, and stiffness in the muscles and connective tissues. The cause is not known. Six million people or more in the U.S. may have it, Gillis says. Usually doctors take a medical history and note symptoms. Often, it is a diagnosis made after excluding other diseases.

"The biggest problem is the skepticism that physicians have that don't believe that fibromyalgia is a real medical ailment," Gillis says. Often, he says, they label the patient as being depressed or being a hypochondriac.

"What our test does more than anything else is legitimize the diagnosis," Gillis says.

The test measures proteins in the body that lessen pain. "In patients with fibromyalgia, they cannot produce normal quantities of these proteins," Gillis says.

The test developers compared the blood test results in:

Ninety-three percent of the people who had fibromyalgia were identified correctly with the test, Gillis says, and 89% of those who did not were correctly identified.

Zashin, who is not involved with the company, says additional studies will be helpful. "If results could be verified, I would discuss the test with patients in whom the diagnosis of fibromyalgia is being considered to determine if they wanted to obtain the information provided by the testing,'' he says.

These findings were presented at a medical conference. They should be considered preliminary, as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.

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