| Anticonvulsants, also called antiepileptic drugs | | | | In addition, pregabalin significantly improved sleep |
| (abbreviated "AEDs"), are a diverse group of | | | | quality and fatigue!! |
| pharmaceutical used in the treatment of epileptic | | | | To demonstrate improvements in the core |
| seizures. There has also been an increase in their | | | | symptoms of pain, sleep and fatigue represents |
| use with treatment of bipolar disorder, since it | | | | an important advance, particularly as there are no |
| seems to act as mood stabiliser. | | | | approved treatments for this condition. |
| Gabapentin and Pregabalin both of which are | | | | The most common dose-related side effects |
| anticonvulsants can be used for chronic pain | | | | reported by patients were dizziness and |
| (especially migraines and neuropathy). They include | | | | drowsiness. Most adverse events were mild to |
| drugs with very different modes of action, but | | | | moderate in intensity, and many resolved during |
| are also effective for sleeping problems, anxiety | | | | the study. Seventy-eight percent of all patients |
| and depression. | | | | completed the study. |
| They can also relieve fatigue, flu-like symptoms, | | | | Developed by Pfizer, pregabalin has been studied |
| cognitive dysfunction, neurological symptoms, | | | | in an extensive clinical program involving over |
| irritable bowel syndrome (IBS), bladder problems, | | | | 8,000 patients worldwide. The company has |
| restless legs, muscle tension and multiple chemical | | | | completed pivotal studies to support the filing of a |
| sensitivity. Their ability to tackle many symptoms | | | | New Drug Application for pregabalin for the |
| at once has made them one of the most | | | | treatment of neuropathic pain and generalized |
| important drugs in the treatment of CFS/ME. | | | | anxiety disorder and as an add-on therapy for |
| Because anticonvulsants work by different | | | | epilepsy. |
| mechanisms, their side effects vary too - | | | | Carbamazepine (Tegretol) Carbamazepine is an old |
| obviously these depend on the individual and some | | | | inexpensive anticonvulsant which has sometimes |
| people do not get any side effects. The older | | | | been used in CFS/ME. It is particularly effective |
| ones can very rarely cause liver problems and | | | | for sharp and stabbing neuropathic pain. It can |
| other severe reactions. On the other hand, the | | | | cause liver damage and other serious problems, |
| newer ones are more prone to causing sedation. | | | | so safer alternatives have mostly surpassed it |
| Headaches, dizziness and vision impairment are | | | | and is not in widespead use today. |
| common side effects. Some anticonvulsants can | | | | Oxcarbazepine (Trileptal) is a newer derivative of |
| cause weight gain, but a few (topiramate, | | | | carbamazepine with similar efficacy and uses, but |
| vigabatrin and zonisamide) may lead to weight | | | | it may be less likely to cause some of the serious |
| loss. | | | | adverse reactions. |
| Gabapentin (Neurontin) is one of the most popular | | | | Lamotrigine (Lamictal) Lamotrigine affects many |
| treatments for CFS/ME and fibromyalgia. It can | | | | neurotransmitters and receptors in the brain. It |
| alleviate a wide variety of problems from | | | | also has some antiviral activity against HHV-6, a |
| interstitial cystitis to hot flashes. It is often used | | | | herpes virus which has been associated with CFS |
| for anxiety and mood problems. It is also a | | | | ME. Some people with CFS/ME have found it |
| popular pain treatment, especially for burning or | | | | extremely useful. |
| electric shock-like neuropathy. | | | | Unfortunately lamotrigine can cause a |
| Pregabalin (Lyrica) Pregabalin is very similar to | | | | life-threatening rash. This is very rare, but up to |
| gabapentin, but may be slightly better tolerated. It | | | | 10% of the patients develop some sort of a rash |
| was the first FDA-approved drug for fibromyalgia, | | | | (usually harmless), so the drug is often |
| though there is no evidence that it is more | | | | discontinued just in case. |
| effective in this use than the less expensive | | | | Levetiracetam (Keppra) Levetiracetam may be |
| gabapentin. | | | | the antidepressant with best tolerability and |
| It is used for treating pain caused by neurologic | | | | fewest side effects. It is often useful in RLS and |
| diseases such as postherpetic neuralgia as well as | | | | migraine (especially migraine with aura). It may |
| seizures. It also is used for treating fibromyalgia. | | | | also help refractory cases of chronic pain and |
| The mechanism of action of pregabalin is | | | | PTSD. |
| unknown. | | | | Clonazepam (Klonopin) Clonazepam belongs to |
| Pregabalin binds to calcium channels on nerves and | | | | benzodiazepines, a class of tranquilizer drugs. It is |
| may modify the release of neurotransmitters | | | | sometimes used for sleeping problems and for its |
| (chemicals that nerves use to communicate with | | | | muscle relaxing properties. It is also an |
| each other). Reducing communication between | | | | anticonvulsant. Many CFS/ME and fibromyalgia |
| nerves may contribute to pregabalin's effect on | | | | experts believe that in low doses clonazepam is |
| pain and seizures.pregabalin was shown to provide | | | | one of the best treatments for these illnesses. |
| improvement of pain in patients with fibromyalgia, | | | | Other Alternatives Topiramate (Topamax) is |
| a chronic and debilitating pain syndrome and is also | | | | often used in migraine prophylaxis (prevention) |
| shown shown to improve sleep and fatigue levels. | | | | and may also help neuropathic pain, but it is quite |
| Fibromyalgia syndrome (FMS) is a chronic disorder | | | | prone to causing cognitive impairment. Tiagabine |
| characterized by widespread musculoskeletal pain | | | | (Gabitril) is good for anxiety and sleep and a |
| that is frequently associated with fatigue and | | | | preliminary study found it effective in fibromyalgia. |
| sleep disturbances and is is a complaint that is | | | | Zonisamide (Zonegran) is currently being tried for |
| frequently associated with CFS. It is estimated to | | | | the combination of fibromyalgia and migraine in a |
| affect two percent of the population, or 5.6 million | | | | clinical trial. |
| Americans, and occurs most frequently in women. | | | | Afterward: |
| The double-blind, placebo-controlled monotherapy | | | | Reader aware!! Please note that I am not a |
| study involved 529 patients diagnosed with FMS. | | | | medical profession and that this article is being |
| Patients were randomized to receive placebo or | | | | used as a means to promote my website which |
| pregabalin (150 mg, 300 mg or 450 mg per day) | | | | is involved in the bringing about an awareness of |
| for eight weeks. The study evaluated the | | | | Chronic fatigue Syndrome. I do however have |
| efficacy and safety of pregabalin for the | | | | significant experience with the disease itself and |
| treatment of pain and associated symptoms such | | | | am concerned deeply by the effects that it has |
| as sleep and fatigue. Patients were required to | | | | on anyone suffering from it. |
| characterise and record their pain on a daily basis | | | | My wife Amanda has CFS and suffers immensely |
| in detailed diaries. | | | | and it is my experience with her and my |
| Pregabalin-treated patients (450 mg/day) showed | | | | subsequent research into CFS that is the basis of |
| statistically significant improvements in pain | | | | the information above. |
| compared to those who received placebo. | | | | If you are interested in discussing issues related |
| Further, 29 percent of pregabalin-treated patients | | | | to CFS & ME we have a web-site that tries |
| reported at least a 50 percent reduction in pain, | | | | to help people, organises events to promote |
| compared with a reduction of 13 percent for | | | | awareness and raises funds through various |
| patients who received placebo, a difference that | | | | means. |
| was statistically significant. | | | | |