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I prefer Lyrica to neurontin for diabetic neuropathy because of compliance issues and I think it works better.Does anyone have any opinions on this?

Overall, Lyrica is MUCH better than neurontin- It appears to be more effective with less sideFX and a quicker ramp up and down. That's my experience, however some patients do quite well with Neurontin so there is no reason to switch them.

Lyrica, I feel is a much better modulator of neuropathic impulses at a lower dose than neurontin....but I agree, don't switch if symptoms are under control. But, remember we must always stress the importance of good BS control.....this is truely the best way to control painful peripheral neuropathy.

Just one opinion.

I agree that if the patients are doing well with neurontin,then why change?On the other hand,I do prefer to start them on Lyrica.

I had a patient the other day whose insurance company did not approve Lyrica but did approve Neurontin (I am in the US). They wished to pay out of pocket so I called a pharmacy for the cost. Surprisingly, a days supply of Lyrica is the same cost as a days worth of GENERIC Neurontin ( the per pill cost is lower but you must take twice as many ).

The only thing that is a pain in the neck re Lyrica is the authorization and Medicare part D or insurance issues.Neurontin does not give me the same results as lyrica!

Does this work well with patients with peripheral neuropathy without diabetes being the underlying cause? ie Non diabetics?
Mark.

Empirically I do not see why not.

I have had no experience with neuropathy due to anything but diabetes, though I know they exist.

Do these other causes produce the same type of neuropathy as diabetes ie: distal, bilateral, symmetrical, nocturnal neuropathy?

Rebecca

Surgical damage to nerve paths of lower limb.....my mum has a great case of Tib ant and peroneals failure with a lot of neuropathic pain....has had a lot of neurontin...not sure about Lyrica...have to find out...long term atrophy and loss of balance and strength, uses an AFO sometimes

I would guess that they nondiabetic causes of neuropathy give the same set of symptoms.There are differences,for insance sciatid nerve pain would cause pain that is relieved by bending-"shopping cart sign"

I am not aware of any double blinded studies as of yet. I have tried to prescribe Lyrica and the insurance companies her in the U.S. are almost never willing to pay for it.

Dear John

There seems to be a great deal of confusion about sciatic nerve pain versus somatic referred pain.

Sciatica by definition (definiton of pain 1994) states that sciatica is a pain that travels down the back of the leg (down the crease of your trousers), in the following manner. It is described as: lightening bolts, electric shocks, extreme pain that one has never felt before. This is sciatica. It is extremely rare to say the least. The only cause of scaiatica is compression of the cells in the dorsal horn of the spinal cord which is found in the lateral recess. The commonest cause is discal lateral protrusion. Almost 100% of pain is caused by this method.

Any other pain is referred somatic pain. There are over 240 structures that can cause pain down the leg (Renee Calliet).

As nerves do not have nerves of their own, they cannot tell you where the injury is.

Neuropathy and neuritis are TRUE damage to the nerve itself. Thus their specific way of complaining, ie pain.


If you compress a normal nerve you only get: paraesthesia (pins and needles) and numbness, NEVER pain.

Thus there are many markers that can tell you what is happening where and when.

You do not need to use imaging when the history is clear. Thus history is everything.

Hope this helps.

musmed

www.musmed.com.au

John

Quickly,

Most people who have confusion and cannot remember simple things as in 'a seniors moment' are quickly lost with changing to Lyrica.

Neurontin 200mg cost about 130 AU per 100 but if you write a script for Lyrica is far less at a lower dose. Using the chemical name often means about a 50% or more reduction in price.

I agree Lyrica seems to work better and it has a far better patient compliance.

musmed
musmed.com.au