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Lyrica vs Elavil
Introduction
Lyrica and Elavil are two common medications that can help manage nerve pain or certain types of chronic pain disorders. Both drugs work by altering the actions of chemicals in the brain, which can reduce discomfort and pain for individuals. Lyrica, also known as pregabalin, is classified as an anticonvulsant or anti-seizure medication with analgesic properties; it works primarily by reducing the number of pain signals sent out by damaged nerves in your body. On the other hand, Elavil (amitriptyline) falls under a class called tricyclic antidepressants; this drug increases levels of norepinephrine and serotonin while blocking acetylcholine to provide relief from chronic pains associated with conditions like fibromyalgia or neuropathic pain disorders.
Lyrica vs Elavil Side By Side
| Attribute | Lyrica | Elavil |
|---|---|---|
| Brand Name | Lyrica | Elavil |
| Contraindications | Should not be taken with MAO inhibitors or by individuals with known allergies to pregabalin. Caution in patients with a history of depression or suicidal thoughts. | Should not be taken with MAO inhibitors or by individuals with known allergies to amitriptyline. Caution in patients with a history of heart conditions, urinary retention, glaucoma, or increased intraocular pressure. |
| Cost | Brand name: around $470 for 60 capsules (75 mg). Generic: from around $0.50/day to about $2/day depending on daily dose. | Brand name: around $90 for 30 tablets (25 mg). Generic: typically between just over pennies per day and up to about half a dollar per day depending on the daily dose. |
| Generic Name | Pregabalin | Amitriptyline |
| Most Serious Side Effect | Thoughts about suicide or self-harm, signs of an allergic reaction, vision problems, heart issues, low platelet levels, muscle problems. | Signs of an allergic reaction, changes in mood or behavior, vision problems, rapid heartbeat, seizures, signs of a manic episode. |
| Severe Drug Interactions | MAO inhibitors, risk of serotonin syndrome when combined with other serotonergic drugs. | MAO inhibitors, increased risk of serotonin syndrome with other serotonergic drugs, potentially dangerous interactions with anticholinergic drugs. |
| Typical Dose | Starts at 50 mg three times a day (150 mg/day), can be increased to 100 mg three times a day (300 mg/day) within one week, up to a maximum of 600 mg/day. | Starts at 75 mg/day, can be divided into two or three smaller doses, gradually increased to a maximum of 150 mg/day. |
What is Lyrica?
Pregabalin (the generic name for Lyrica) is a drug from the class known as gabapentinoids, which are generally used to treat neuropathic pain and fibromyalgia. Pregabalin was first approved by the FDA in 2004. Lyrica works by slowing down impulses in the brain that cause seizures and affects chemicals in the brain that send pain signals across the nervous system. It is prescribed for nerve damage caused by diabetes, spinal cord injuries, and certain types of seizures.
On the other hand, Amitriptyline (the generic name for Elavil) belongs to an older class of antidepressant drugs known as tricyclic antidepressants (TCAs). Apart from treating depression, Elavil also shows efficacy in treating chronic pain such as migraines or neuropathic discomforts. By increasing levels of neurotransmitters like serotonin and norepinephrine while blocking another neurotransmitter acetylcholine, it helps balance out mood levels whilst simultaneously managing pain sensations.
However, due to its broader effect on various neurotransmitters compared to Lyrica's more targeted approach affecting specific nerves involved with seizure activity and pain signals; Elavil may have a higher risk of causing side effects.
What conditions is Lyrica approved to treat?
Lyrica is approved for the treatment of various types of neurological and psychiatric disorders:
- Neuropathic pain associated with diabetic peripheral neuropathy
- Postherpetic neuralgia (pain from damaged nerves that can occur after shingles)
- Fibromyalgia, a chronic pain condition
- Neuropathic pain associated with spinal cord injury
- As an adjunctive therapy for partial onset seizures in patients 17 years of age and older.
How does Lyrica help with these illnesses?
Lyrica, also known as pregabalin, is a medication that manages nerve pain by decreasing the amount of pain signals sent out by damaged nerves in the body. It accomplishes this by binding to calcium channels found on nerve cells in the brain and spinal cord. This process reduces neurotransmitter release from these neurons which ultimately leads to decreased perception of pain. Neurotransmitters are chemicals that allow nerve cells to communicate with each other, playing key roles in functions like mood regulation, sleep patterns, cognition and overall sensory processing. The unique way Lyrica interacts with these neural processes enables it to alleviate symptoms associated with conditions such as fibromyalgia, diabetic neuropathy and postherpetic neuralgia (shingles). By reducing the intensity of pain signals transmitted by affected nerves, Lyrica can help patients manage their condition effectively.
What is Elavil?
Elavil is the brand name for amitriptyline, a tricyclic antidepressant drug (TCA) that increases the levels of norepinephrine and serotonin in the brain by reducing their reabsorption. It also has anticholinergic effects, meaning it blocks the action of acetylcholine at muscarinic acetylcholine receptors. Amitriptyline was first approved by FDA in 1961. As amitriptyline operates as an SSRI antidepressant, it does inhibit the reuptake of serotonin unlike Lyrica which doesn't have this function. Its interaction with serotonin means that its side-effect profile includes potential weight gain and sexual dysfunction (common side effects seen with other SSRIs), however Elavil typically causes less sedation compared to many SSRIs such as Prozac. The enhanced effect on norepinephrine can be beneficial for treating depression particularly in patients who do not respond well to “typical” SSRI drugs or newer alternatives like Lyrica.
What conditions is Elavil approved to treat?
Elavil, a tricyclic antidepressant medication, has been approved for the treatment of:
- Major depressive disorder (MDD)
- Neuropathic pain in adults Additionally, even though not officially approved by the FDA for this use, it is frequently prescribed off-label to help manage chronic pain and fibromyalgia symptoms.
How does Elavil help with these illnesses?
Elavil, also known as amitriptyline, is a tricyclic antidepressant that increases the amounts of certain natural substances in the brain such as serotonin and norepinephrine. These chemicals are neurotransmitters that transmit signals between nerve cells and play significant roles in regulating mood, sleep and response to stress. Elavil has been proven effective in treating depression symptoms by elevating these neurotransmitter levels. It's sometimes prescribed when patients don't respond well to newer classes of antidepressants like SSRIs or SNRIs, similar to how Lyrica might not work for all patients with fibromyalgia or neuropathic pain. Additionally, because Elavil can affect other systems such as histamine receptors causing sedation and acetylcholine receptors possibly leading to dry mouth and constipation; it may be chosen specifically for its broader effects when suitable for individual patient circumstances.
How effective are both Lyrica and Elavil?
Both pregabalin (Lyrica) and amitriptyline (Elavil) are effective in treating various types of pain, particularly neuropathic pain. Amitriptyline was first approved by the FDA in 1961 as an antidepressant, while pregabalin received its approval in 2004 for managing neuropathic pain associated with diabetic peripheral neuropathy and postherpetic neuralgia. They act differently: Lyrica is a gabapentinoid that works by binding to certain parts of calcium channels in nerve cells, while Elavil is a tricyclic antidepressant that affects several neurotransmitters, including serotonin and norepinephrine.
A head-to-head comparison study published in 2010 revealed similar efficacy between these two drugs for reducing pain intensity scores among patients with painful diabetic peripheral neuropathy. However, Lyrica demonstrated a faster onset of action compared to Elavil.
In terms of safety profiles, both medications can cause drowsiness or sedation which often improve over time or with dose adjustment. Other common side effects include dizziness for Lyrica users and dry mouth for those on Elavil. It's crucial to understand that despite the potential benefits highlighted here, both medications may not be suitable for everyone due to their unique pharmacological properties; specific patient characteristics such as age, other medical conditions and potential interactions with other medications also need consideration when deciding between these treatments.
Finally yet importantly - although they have shown good results against depression symptoms due to their mechanism - neither medication should replace standard treatment options like SSRIs without proper medical guidance.
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At what dose is Lyrica typically prescribed?
Oral dosages of Lyrica for the management of neuropathic pain associated with diabetic peripheral neuropathy start at 50 mg three times a day (150 mg/day), but can be increased to 100 mg three times a day (300 mg/day) within one week based on efficacy and tolerability. Patients who do not experience sufficient relief with 300 mg/day may be further increased to 200 mg three times daily (600mg/day). In contrast, Elavil is usually started at a low dose of about 10-25mg per night, which can gradually increase up to around 75-150mg per night depending on individual response and tolerance. The maximum dosage that should not be exceeded in any case is usually close to or around 300mg nightly.
At what dose is Elavil typically prescribed?
Elavil treatment typically begins at a dosage of 75 mg/day, which can be divided into two or three smaller doses. If tolerated well by the patient, this dose can then be gradually increased to a maximum of 150 mg/day. This is also split into two or three separate doses throughout the day. It's important to note that if there is no noticeable improvement in symptoms after several weeks at an increased dosage, your healthcare provider may consider other therapeutic options for your condition.
What are the most common side effects for Lyrica?
Common side effects of Lyrica (Pregabalin) include:
- Dizziness
- Somnolence (sleepiness/drowsiness)
- Dry mouth
- Swelling of hands and feet
- Weight gain
- Blurred vision
- Difficulty concentrating or attention
- Uncoordinated movement
- Tremors
On the other hand, Elavil (Amitriptyline) may cause:
- Dry mouth
- Constipation
- Blurred Vision
- Increased heart rate
- Sudden drop in blood pressure upon standing up causing lightheadedness
- Weight gain
- Difficulty urinating.
Some serious but rare side effects include a rash, swelling particularly on face, lips or throat indicating an allergic reaction and irregular heartbeat. Always consult your healthcare provider for any concerns related to medication use.
Are there any potential serious side effects for Lyrica?
While Lyrica is generally well-tolerated, there are a few potential serious side effects to be mindful of:
- Thoughts about suicide or self-harm
- Signs of an allergic reaction such as hives, having trouble breathing, swelling in your face or throat, fever with severe blistering and red skin rash
- Vision problems including blurred vision, double vision
- Heart issues: chest pain and discomfort; irregular heartbeat that could cause shortness of breath
- Low platelet levels leading to easy bruising and bleeding
- Muscle problems: muscle weakness or tenderness (especially if you also have a fever), numbness or loss of movement in any part of your body.
If these occur it's important that you stop taking Lyrica and seek medical attention immediately. Similarly to Elavil, it also carries the risk for serotonin syndrome - symptoms include agitation, hallucinations, rapid heartbeat, fever, overactive reflexes.
What are the most common side effects for Elavil?
Taking Elavil may result in the following side effects:
- Dry mouth and a sore throat
- Blurred vision
- Changes in appetite, which could lead to weight gain or loss
- Constipation or urinary retention
- Dizziness or faintness (especially upon standing)
- Insomnia and unusual dreams
- Fatigue or lethargy
- Increased heart rate
- Confusion, forgetfulness, or mental clouding
- Anxiety, restlessness, agitation
-Nausea and vomiting
-Skin rash
-Muscle weakness or joint pain.
It's important to note that not everyone experiences these side effects; they are potential risks associated with this medication.
Are there any potential serious side effects for Elavil?
While Elavil is generally well-tolerated, it can occasionally have significant side effects. These may include:
- Signs of an allergic reaction, such as itching or hives, swollen glands in your neck or face, difficulty breathing or swallowing and severe skin rashes with blistering and peeling.
- Changes in mood or behavior that are out of character including agitation, hostility, panic attacks, insomnia or feelings of impulsivity.
- Vision problems like blurred vision,having tunnel visions seeing halos around lights along with eye pain and swelling could be a sign to stop the medication immediately
- Rapid heartbeat which might present as palpitations
- Seizures (convulsions) Lastly, -Signs indicative of a manic episode: racing thoughts; increased energy levels leading to reckless behaviour; extreme happiness or irritability; talking more than usual; severe sleeping issues.
If you notice any of these symptoms after starting treatment with Elavil, it's crucial that you seek immediate medical attention.
Contraindications for Lyrica and Elavil?
Both Lyrica and Elavil, along with most other medications used for nerve pain or depression, may worsen symptoms of depression in some people. If you notice your mood worsening, have suicidal thoughts or experience any significant changes in behavior while on these drugs, please seek immediate medical attention.
Neither Lyrica nor Elavil should be taken if you are currently taking MAO inhibitors (MAOIs), or have been taking them recently. Always inform your physician about all the medications that you're using; MAOIs will require a period of about 2 weeks to clear from the system to prevent dangerous interactions with both Lyrica and Elavil.
How much do Lyrica and Elavil cost?
For the brand name versions of these drugs:
- The price of 60 capsules of Lyrica (75 mg) averages around $470, which works out to approximately $15.67/day at a typical dosage.
- The price for 30 tablets of Elavil (25 mg) is around $90, roughly working out to be about $3/day.
Therefore, if you're on a higher dosage range for Lyrica (i.e., 300 mg per day), then brand-name Elavil becomes less expensive on a per-day treatment basis. Please note that cost should not be your primary consideration in determining which medication is best suited for you.
As far as generic versions are concerned:
- Pregabalin (the generic version of Lyrica), is available in packs from 14 up to hundreds with costs starting from around $0.50/day and could go up to about $2/day depending on your daily dose.
- Amitriptyline HCl (generic Elavil) has similar packaging options, but costs significantly lower — typically between just over pennies per day and up to about half a dollar per day depending upon the daily dose.
Popularity of Lyrica and Elavil
Pregabalin, commonly known by the brand name Lyrica, is an anticonvulsant and neuropathic pain medication. In 2020, it was estimated that about 10.6 million prescriptions for pregabalin were filled in the US. This accounts for a significant proportion of medications prescribed within its class.
On the other hand, Amitriptyline, widely known as Elavil, is a tricyclic antidepressant often used off-label to manage chronic pain conditions like fibromyalgia or neuropathic pain. In 2020, around 8 million people in the USA were prescribed amitriptyline. Notably though, despite being classified as an antidepressant similar to fluoxetine (Prozac), its use today leans more towards managing chronic pain rather than treating depression.
Both drugs have seen consistent prescription numbers over recent years with no drastic increases or decreases in prevalence.
Conclusion
Both Lyrica (pregabalin) and Elavil (amitriptyline) have extensive histories of use in managing chronic pain conditions, including fibromyalgia and neuropathic pain. Numerous clinical studies back up their efficacy over placebo treatments. In some instances, they may be used together under careful medical supervision as they interact with each other. They operate via different mechanisms; Lyrica primarily works on calcium channels to decrease the release of pain neurotransmitters while Elavil is a tricyclic antidepressant that affects serotonin and norepinephrine reuptake.
Lyrica is often considered first-line treatment for fibromyalgia and various forms of neuropathy, whereas Elavil would typically be considered if patients do not respond well to first-line medications or in cases where there's concurrent depression or sleep disorders which can also be addressed by this drug.
Both drugs are available in generic form - an important consideration for those paying out-of-pocket. Both Lyrica and Elavil may require adjustment periods meaning effects might not manifest immediately.
The side effect profile differs: both are generally well-tolerated but side effects such as dizziness, dry mouth, weight gain, constipation can occur more frequently with Elavil than with Lyrica. Lyrica may cause peripheral edema (swelling), particularly in older adults. Patients using either medication should closely monitor any changes especially when starting therapy or changing doses, seeking immediate medical help if adverse reactions arise.
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Refrences
- Acet, G. (2017). The Comparation of the Effectiveness of Amitriptilin and Pregabalin Treatment in Fibromyalgia Patients. Northern Clinics of Istanbul. Kare Publishing.http://doi.org/10.14744/nci.2017.61687
- Taylor, C. P., Angelotti, T., & Fauman, E. (2007, February). Pharmacology and mechanism of action of pregabalin: The calcium channel α2–δ (alpha2–delta) subunit as a target for antiepileptic drug discovery. Epilepsy Research. Elsevier BV.http://doi.org/10.1016/j.eplepsyres.2006.09.008
- Scharfetter, C. (1965). Vergiftung mit einem Antidepressivum. Archiv f�r Psychiatrie und Nervenkrankheiten Vereinigt mit Zeitschrift f�r die Gesamte Neurologie und Psychiatrie. Springer Science and Business Media LLC.http://doi.org/10.1007/bf00343771
- Sicras-Mainar, A., Rejas-Gutiérrez, J., Pérez-Paramo, M., Sánchez-Alvarez, L., Navarro-Artieda, R., & Darbà, J. (2018, September 17). Consequences on economic outcomes of generic versus brand-name drugs used in routine clinical practice: the case of treating peripheral neuropathic pain or generalized anxiety disorder with pregabalin. Expert Review of Pharmacoeconomics & Outcomes Research. Informa UK Limited.http://doi.org/10.1080/14737167.2019.1519399
- McClure, E. W., & Daniels, R. N. (2021, January 13). Classics in Chemical Neuroscience: Amitriptyline. ACS Chemical Neuroscience. American Chemical Society (ACS).http://doi.org/10.1021/acschemneuro.0c00467
- Max, M. B., Lynch, S. A., Muir, J., Shoaf, S. E., Smoller, B., & Dubner, R. (1992, May 7). Effects of Desipramine, Amitriptyline, and Fluoxetine on Pain in Diabetic Neuropathy. New England Journal of Medicine. Massachusetts Medical Society.http://doi.org/10.1056/nejm199205073261904