Podcasts about Pregabalin

Listen as Michael S. Blaiss, MD provides case-based perspectives on chronic cough recognition, burden, management, and pathophysiology and describes the evolving treatment landscape for refractory chronic cough.PresenterMichael S. Blaiss, MDClinical Professor of PediatricsDivision of Allergy-ImmunologyMedical College of Georgia at Augusta UniversityAugusta, GeorgiaLink to full program: https://bit.ly/4kweynG

Also, is Belfast a city "drowning in its own filth?"

With tracks from Vegyn, Ian Vale, Coflo, UC Beatz, Johannes Albert, Session Victim, Sister Sledge, Chilly Gonzales, Tech Support, Sam Ruffillo, Fort Romeau, Cale Parks, Chevals, Osunlade, Gigi Croccante, Mount Rushmore Presents The Knack, Skatman, Justice, Keita Sano, DJ Rocca & Mike Riviera, Klára Körmendi. Contact: dj@ribeaud.ch.

Die beiden ÖV-Unternehmen «BLS» und «Bus Ostschweiz» sollen mittels Betrug zu hohe Subventionen bezogen haben. Insgesamt geht es dabei um mehr als 15 Millionen Franken. Fünf ehemalige Verantwortliche der beiden Unternehmen wurden angeklagt. Ausserdem: Der ukrainische Präsident Wolodimir Selenski hat in den vergangenen Wochen einiges dafür getan, um seine Verbündeten von der Notwendigkeit eines nachhaltigen Friedens zu überzeugen. Auffallend war, wie oft er den gewählten US-Präsidenten Trump als starke Figur bezeichnete. Das hat Gründe. Pregabalin wirkt gegen Angststörungen und Epilepsie. Vielfach wird das Medikament als Droge missbraucht, vor allem von Asylsuchenden aus dem Maghreb, wo Pregabalin rezeptfrei erhältlich ist. Wie gehen Aslyzentren mit dem Konsum um? Finanzpolitisch weht der Wind in der Schweiz rauer. Verteilkämpfe zwischen Bund und Kantonen sind programmiert. Eine prägende Figur in Finanzfragen ist seit Jahren der Präsident der Finanzdirektorenkonferenz Ernst Stocker. Er vertritt die Interessen der Kantone in finanzpolitischen Fragen.

Today's sponsor is Freed AI! Freed's AI medical scribe listens, transcribes, and writes notes for you. Over 15,000 healthcare professionals use Freed and you should too! Learn more here! On this episode of the Top 200 Drugs Podcast, I cover medications 151-155. This podcast includes; cefuroxime, ketoconazole, pregabalin, esomeprazole, and ipratropium/albuterol. Cefuroxime is a 2nd generation cephalosporin that has a very similar bacterial coverage profile to amoxicillin. It has significant gram positive coverage. Ketoconazole is an azole antifungal medication. It is well known for causing hepatotoxicity as well as interactions via CYP3A4. Pregabalin has a lot of similarities with gabapentin. It can be used fo various pain syndromes such as neuropathy and fibromyalgia. Esomeprazole is a PPI and has a similar profile to omeprazole. It inhibits CYP2C19 and has a few notable interactions that I cover in this episode. Ipratropium and albuterol is a combination of a short acting anticholinergic and short acting beta agonist.

Der Kanton Basel-Stadt prüft die Abgabe von Pregabalin. Dieses rezeptpflichtige Medikament ist vor allem unter Männern aus dem Maghreb verbreitet und führt oft in die Abhängigkeit. Ausserdem: · A98 als Alternative zum Rheintunnel? Deutschland sagt Nein · Überfall auf Apotheke in Birsfelden

Das rezeptpflichtige Medikament Pregabalin ist bei Menschen aus Maghreb-Staaten stark verbreitet und kann süchtig machen. Um zu verhindern, dass sich die Süchtigen das Medikament auf dem Schwarzmarkt beschaffen, prüft der Kanton Basel-Stadt die Abgabe von Pregabalin. Ausserdem: · Seit 10 Jahren verbindet das Tram 8 Basel mit Weil am Rhein. Wie gut funktioniert der grenzüberschreitende Verkehr? Eine Bilanz. · Der Kanton Baselland will die Brückenangebote verstaatlichen. Das sorgt für Kritik.

Un nouvel épisode du Pharmascope est disponible! Dans ce 145e épisode, Nicolas, Isabelle et Olivier essaient de ne pas trop vous faire trembler en revisitant une vieille littérature et un problème incommodant : le tremblement essentiel. Les objectifs pour cet épisode sont les suivants: Expliquer l'épidémiologie, la présentation clinique et l'évaluation du tremblement essentiel. Conseiller des mesures non-pharmacologiques pour aider les personnes avec un tremblement essentiel. Discuter des bénéfices et des désavantages associés aux principaux traitements pharmacologiques du tremblement essentiel. Ressources pertinentes en lien avec l'épisode  Shanker V. Essential tremor: diagnosis and management. BMJ. 2019 Aug 5;366:14485 Welton T, Cardoso F, Carr JA, Chan LL, Deuschl G, Jankovic J, Tan EK. Essential tremor. Nat Rev Dis Primers. 2021 Nov 11;7(1):83. Baizabal-Carvallo JF, Morgan JC. Drug-induced tremor, clinical features, diagnostic approach and management. J Neurol Sci. 2022 Apr 15;435:120192 Ferreira JJ et coll. MDS Task Force on Tremor and the MDS Evidence Based Medicine Committee. MDS evidence-based review of treatments for essential tremor. Mov Disord. 2019 Jul;34(7):950-958. Serrano-Dueñas M. Use of primidone in low doses (250 mg/day) versus high doses (750 mg/day) in the management of essential tremor. Double-blind comparative study with one-year follow-up. Parkinsonism Relat Disord. 2003 Oct;10(1):29-33. Bruno E, Nicoletti A, Quattrocchi G, Allegra R, Filippini G, Colosimo C, Zappia M. Topiramate for essential tremor. Cochrane Database Syst Rev. 2017 Apr 14;4(4):CD009683. Ondo WG, Jankovic J, Connor GS, Pahwa R, Elble R, Stacy MA, Koller WC, Schwarzman L, Wu SC, Hulihan JF; Topiramate Essential Tremor Study Investigators. Topiramate in essential tremor: a double-blind, placebo-controlled trial. Neurology. 2006 Mar 14;66(5):672-7. Bruno E, Nicoletti A, Quattrocchi G, Filippini G, Colosimo C, Zappia M. Pregabalin for essential tremor. Cochrane Database Syst Rev. 2016 Oct 20;10(10):CD009682 Bruno E, Nicoletti A, Quattrocchi G, Filippini G, Zappia M, Colosimo C. Alprazolam for essential tremor. Cochrane Database Syst Rev. 2015 Dec 6;2015(12):CD009681. Marques A et coll. Trial of Botulinum Toxin for Isolated or Essential Head Tremor. N Engl J Med. 2023 Nov 9;389(19):1753-1765. Yetimalar Y, Irtman G, Kurt T, Başoğlu M. Olanzapine versus propranolol in essential tremor. Clin Neurol Neurosurg. 2005 Dec;108(1):32-5.

Gross, Horst www.deutschlandfunkkultur.de, Zeitfragen

Das Schmerzmittel Pregabalin sorgt in Bern für Unruhe. Es macht abhängig, und wer zu viel konsumiert oder auf Entzug ist, wird aggressiv. Das stellt die Polizei und die Asylbehörden vor Probleme, denn Pregabalin wird immer häufiger von Asylsuchenden aus nordafrikanischen Ländern konsumiert. Weiter in der Sendung: * Cannabis-Studie: In der Stadt Bern können neu mehrere hundert Personen in ausgewählten Apotheken Cannabis-Produkte beziehen. * Kokain- und Ketaminhandel: Der Kantonspolizei Freiburg gelingt Schlag gegen Drogenring.

Neues Tierschutzgesetz - kommt jetzt das Ende von Tierversuchen? Insektenfreundliche Samenmischungen blühen zu spät | Pregabalin - Wie gefährlich ist der Wirkstoff? | Was zeigt der Sternenhimmel im April?

Dive into the realm of advanced pain management with Dr. Mark Epstein, as he unveils the latest on Tramadol, Gabapentinoids, and more in our dedicated pain management series. Quick Summary: This episode, part of a five-episode series from a comprehensive workshop held in late 2023, focuses on Tramadol, Gabapentinoids, and their roles in veterinary pain management. Dr. Mark Epstein, a renowned expert, discusses the effectiveness, applications, and considerations of these medications in dogs and cats, offering practitioners insights to enhance patient care. Speaker: Dr. Mark Epstein, DVM, DABVP, CVPP, a leading authority in veterinary pain management, shares his expertise. Dr. Epstein is the medical director at Total Bond Veterinary Hospitals, North Carolina, and a celebrated figure in the field, having led significant pain management guideline programs. Main Talking Points: Tramadol's Efficacy: Exploration of Tramadol's varying effectiveness in dogs versus cats, highlighting its limitations and potential uses. Gabapentinoids: Discussion on Gabapentin and Pregabalin's roles in treating neuropathic pain, with specific dosing insights for both species. Emerging Therapies: Introduction to promising medications like Amantadine and Acetaminophen, outlining their contributions to multi-modal pain management strategies. Interesting Quotes: "The conversations about Tramadol... pretty much settled by now that the oral form of it in dogs is simply no strong evidence that it's effective." - Dr. Epstein "When it comes to dogs... we need more evidence to show it. So this is like going to be a therapeutic in progress of its study." - Dr. Epstein on Tapentadol "We can say with some confidence that [Gabapentinoids] can have a benefit when there's a neuropathic component to pain." - Dr. Epstein Timestamps: 0:00 - Introduction  2:05 - Tramadol's efficacy and limitations 5:40 - Gabapentinoids in pain management 10:25 - Insights into Amantadine and Acetaminophen 11:00 - Final thoughts   Visit IVDI.org to learn more about the Veterinary Dental Practitioner Program. Tune in next week for more insights into veterinary dentistry and pain management.   This episode provides a deep dive into the complexities of using Tramadol and Gabapentinoids for managing pain in veterinary patients, guided by Dr. Mark Epstein's rich experience and research. By dissecting the latest findings and practical considerations, veterinarians and technicians can glean valuable strategies for optimizing pain management in their practice. Affiliate & Sponsor Links: This series is brought to you by the International Veterinary Dentistry Institute (IVDI.org), offering comprehensive training to elevate your veterinary dentistry skills.

Jo Cheah chats with clinical pharmacologist Richard Day about off-label prescribing. Ric explains why off-label prescribing occurs, the barriers to getting new indications added to a drug's approved label, and the potential risks of off-label prescribing without sufficient evidence. Read the full article by Richard Day in Australian Prescriber.

3.400 Menschen sind in Großbritannien in den vergangenen fünf Jahren gestorben, nachdem sie Pregabalin genommen hatten. Der Wirkstoff wird auch hierzulande millionenfach bei Epilepsie, Schmerzen oder Angststörungen verschrieben. Wir fragen in unserer heutigen Podcast Folge: Welche Risiken gehen Patienten, die das Mittel nehmen, ein?

Pregabalin - Wie gefährlich ist der Wirkstoff? / Antarktis - Wie Geopolitische Spannungen die Forschung beeinträchtigen.

Dr. Angie Skuse, GP and Medical Director of SafetyNet

On this podcast episode, I discuss (Lyrica) pregabalin pharmacology, adverse effects, drug interactions, and much more. I compare pregabalin and gabapentin in this episode and one important difference is the percent absorption of gabapentin compared to pregabalin. Pregabalin can exacerbate the risk of respiratory depression and overdose in patients who are taking opioids. Pregabalin is most frequently used in practice for neuropathic pain syndromes.

Listen to Dr. Tom Roselle, DC discuss the difference between fibromyalgia and chronic pain, including distinguishing symptoms of the two conditions and resolving the neuropathic pain beyond medications like Gabapentin and Pregabalin. Gabapentin and Pregabalin are neuropathic pain medications that can increase the mortality rate by 60% and are also linked to injury, suicide, unintentional overdose, crime, and accidental deaths. For more episodes of Ageless Health® with Dr. Tom Roselle, DC, please visit: https://www.drtomroselle.com/ageless-health-podcast/

Join Matt & Carl as we discuss the two papers here that document the difference between using pregabalin and gabapentin after spinal surgery in dogs. Reflective learning After listening to this podcast do you see a place for gabapentinoids in the management of pain following spinal surgery? How will this understanding impact the management of your current and future patients?  Learning actions Watch Gwen Covey Crump's webinar on gabapentinoids. Watch Matt's webinar on descending modulation which explores the mechanism of action of gabapentinoids. Practice discussion  As a practice team discuss your use of gabapentinoids. References Aghighi SA, Tipold A, Piechotta M, Lewczuk P, Kästner SB. Assessment of the effects of adjunctive gabapentin on postoperative pain after intervertebral disc surgery in dogs. Vet Anaesth Analg. 2012 Nov;39(6):636-46. doi: 10.1111/j.1467-2995.2012.00769.x. Epub 2012 Aug 10. PMID: 22882632. Almeida et al (2023) Evaluation of Gabapentin in the Treatment of Postoperative Pain after a Tibial Plateau Levelling Osteotomy in Dogs DOI https://doi.org/ 10.1055/s-0042-1751069. Crociolli GC, Cassu RN, Barbero RC, Rocha TL, Gomes DR, Nicácio GM. Gabapentin as an adjuvant for postoperative pain management in dogs undergoing mastectomy. J Vet Med Sci. 2015 Aug;77(8):1011-5. doi: 10.1292/jvms.14-0602. Epub 2015 Mar 29. PMID: 25816802; PMCID: PMC4565804. Schmierer, P. A., Tünsmeyer, J., Tipold, A., Hartnack-Wilhelm, S., Lesczuk, P., & Kästner, S. B. R. (2020). Randomized controlled trial of pregabalin for analgesia after surgical treatment of intervertebral disc disease in dogs. Veterinary Surgery, 49(5), 905–913. https://doi.org/10.1111/vsu.13411

Gabapentin is the 10th most prescribed drug in the United States and use is increasing.  In 2002, 1% of adults were taking gabapentinoids (gabapentin and or pregabalin).  By 2015 that number increased to 4% of US adults. There are a lot of reasons that may explain the massive increase in use of these drugs.  One thing is clear, it is not because people are using it for FDA approved indications.  The FDA-approved indications for gabapentin are only for treating patients with partial seizures or postherpetic neuralgia. However, most gabapentin prescriptions are written off-label indications. On today's podcast we talk all about the Gabapentinoids - Gabapentin and Pregabalin - with Tasce Bongiovanni, Donovan Maust and Nisha Iyer.   It's a big episode covering a lot of topics. First, Nisha, a pain and palliative care pharmacist, starts us off with discussing the pharmacology of gabapentin and pregabalin, including common myths like they work on the GABA system (which is weird given the name of the drug).   Tasce, a surgeon and researcher, reviews the use of gabapentin in the perioperative setting and the research she had done on the prolonged use of newly prescribed gabapentin after surgery (More than one-fifth of older adults prescribed gabapentin postoperatively continue to take it more than 3 months later).  Donovan discusses the growth of “mood stabilizers/antiepileptics” (e.g. valproic acid and gabapentin), in nursing homes, particularly patients with Alzheimer's disease and related dementias. This includes a JAGS study recently published in 2022 showing that we seem to be substituting one bad drug (antipsychotics and opioids) with another bad drug (valproic acid and gabapentin). Lastly, we also addressed a big reason for the massive uptake of gabapentinoids: an intentional and illegal strategy by the makers of these drugs to promote off-label use by doing things like creating low-quality, industry-funded studies designed to exaggerate the perceived analgesic effects of these drug.  This long and sordid history of gabapentin and pregabalin is beautifully described in Seth Landefeld and Mike Steinman 2009 NEJM editorial. I could go on and on, but listen to the podcast instead and for a deeper dive, take a look at the following articles and studies: Gabapentin in the Perioperative setting: Prolonged use of newly prescribed gabapentin after surgery. J Am Geriatr Soc. 2022 Perioperative Gabapentin Use in Older AdultsRevisiting Multimodal Pain Management JAMA IM. 2022 Effect of Perioperative Gabapentin on Postoperative Pain Resolution and Opioid Cessation in a Mixed Surgical Cohort.  JAMA Surgery 2018 Gabapentin and mood stabilizers in the Nursing Home Setting: Antiepileptic prescribing to persons living with dementia residing in nursing homes: A tale of two indications. JAGS 2022 Trends in Antipsychotic and Mood Stabilizer Prescribing in Long-Term Care in the U.S.: 2011-2014 JAMDA 2020 Efficacy of Gabapentinoids: Gabapentinoids for Pain: Potential Unintended Consequences. AFP 2019 Gabapentin for chronic neuropathic pain in adults. Cochrane Database of Systematic Reviews Review. 2017 The Illegal Marketing Practices by Pharma promoting ineffective: The Neurontin Legacy — Marketing through Misinformation and Manipulation NEJM 2009 Narrative review: the promotion of gabapentin: an analysis of internal industry documents. Annals of IM. 2006  

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Brought to you by Eight Sleep's Pod Cover sleeping solution for dynamic cooling and heating, Athletic Greens all-in-one supplement, and LMNT electrolyte supplement.Matthew Walker, PhD (@sleepdiplomat), is professor of neuroscience at the University of California Berkeley and founder and director of the school's Center for Human Sleep Science. Walker is the author of the New York Times and international bestseller Why We Sleep: Unlocking the Power of Sleep and Dreams, which was recently listed by Bill Gates as one of his top five books of the year. His TED Talk, “Sleep is Your Superpower,” has garnered more than 17 million views. He has received numerous funding awards from the National Science Foundation and the National Institutes of Health and is a Kavli Fellow of the National Academy of Sciences. In 2020, Walker was awarded the Carl Sagan Prize for Science Achievements. Walker's research examines the impact of sleep on human health and disease. He has been featured on numerous television and radio outlets including 60 Minutes, Nat Geo TV, NOVA Science, NPR, and the BBC. He is also the host of the 5-star-rated podcast The Matt Walker Podcast, which is all about sleep, the brain, and the body.Please enjoy!Resources from this episode: https://tim.blog/2023/01/18/matthew-walker-sleep/*This episode is brought to you by LMNT! What is LMNT? It's a delicious, sugar-free electrolyte drink mix. I've stocked up on boxes and boxes of this and usually use it 1–2 times per day. LMNT is formulated to help anyone with their electrolyte needs and perfectly suited to folks following a keto, low-carb, or Paleo diet. If you are on a low-carb diet or fasting, electrolytes play a key role in relieving hunger, cramps, headaches, tiredness, and dizziness.LMNT came up with a very special offer for you, my dear listeners. For a limited time, you can get a free LMNT Sample Pack with any purchase. This special offer is available here: DrinkLMNT.com/Tim.*This episode is also brought to you by Eight Sleep! Eight Sleep's Pod Cover is the easiest and fastest way to sleep at the perfect temperature. It pairs dynamic cooling and heating with biometric tracking to offer the most advanced (and user-friendly) solution on the market. Simply add the Pod Cover to your current mattress and start sleeping as cool as 55°F or as hot as 110°F. It also splits your bed in half, so your partner can choose a totally different temperature.Go to EightSleep.com/Tim and save $250 on the Eight Sleep Pod Cover. Eight Sleep currently ships within the USA, Canada, the UK, select countries in the EU, and Australia.*This episode is also brought to you by Athletic Greens. I get asked all the time, “If you could use only one supplement, what would it be?” My answer is usually AG1 by Athletic Greens, my all-in-one nutritional insurance. I recommended it in The 4-Hour Body in 2010 and did not get paid to do so. I do my best with nutrient-dense meals, of course, but AG further covers my bases with vitamins, minerals, and whole-food-sourced micronutrients that support gut health and the immune system. Right now, Athletic Greens is offering you their Vitamin D Liquid Formula free with your first subscription purchase—a vital nutrient for a strong immune system and strong bones. Visit AthleticGreens.com/Tim to claim this special offer today and receive the free Vitamin D Liquid Formula (and ten free travel packs) with your first subscription purchase! That's up to a one-year supply of Vitamin D as added value when you try their delicious and comprehensive all-in-one daily greens product.*[05:55] Sleep and Alzheimer's disease.[19:55] What causes the decline of deep sleep as we age?[24:36] Are there any known species that don't require sleep?[29:15] Brain stimulation for more deep sleep, less insomnia.[41:01] Tips for better sleep without laboratory budget or access.[51:45] Ideal types of exercise for promoting deep sleep.[53:51] Matt's updated thoughts on caffeine and sleep.[1:11:12] Cannabis (CBD, THC, CBN) and sleep.[1:30:18] A crowdsourcing request of listeners.[1:36:17] If the bed's a-rocking…[1:41:45] The Da Vinci Code magic sleep device.[1:46:04] DARPA innovation.[1:46:32] Ensuring proper function in the glymphatic system.[1:50:42] Psychedelics and sleep.[2:01:20] How sleep affects food intake and weight fluctuation.[2:10:46] Orexin, I reckon.[2:22:11] Fainting goats and narcolepsy.[2:25:36] Modafinil.[2:30:32] How sleep medications affect sleep quality.[2:36:16] Trazodone.[2:46:26] Perilous polypharmacy.[2:49:04] Pregabalin and gabapentin.[2:54:33] The psychological value of emergency sleep medicine for insomniacs.[2:58:16] CBTI and the balancing role of pharmacology.[2:59:56] Parting thoughts and what to expect from a future round two.*For show notes and past guests on The Tim Ferriss Show, please visit tim.blog/podcast.For deals from sponsors of The Tim Ferriss Show, please visit tim.blog/podcast-sponsorsSign up for Tim's email newsletter (5-Bullet Friday) at tim.blog/friday.For transcripts of episodes, go to tim.blog/transcripts.Discover Tim's books: tim.blog/books.Follow Tim:Twitter: twitter.com/tferriss Instagram: instagram.com/timferrissYouTube: youtube.com/timferrissFacebook: facebook.com/timferriss LinkedIn: linkedin.com/in/timferrissPast guests on The Tim Ferriss Show include Jerry Seinfeld, Hugh Jackman, Dr. Jane Goodall, LeBron James, Kevin Hart, Doris Kearns Goodwin, Jamie Foxx, Matthew McConaughey, Esther Perel, Elizabeth Gilbert, Terry Crews, Sia, Yuval Noah Harari, Malcolm Gladwell, Madeleine Albright, Cheryl Strayed, Jim Collins, Mary Karr, Maria Popova, Sam Harris, Michael Phelps, Bob Iger, Edward Norton, Arnold Schwarzenegger, Neil Strauss, Ken Burns, Maria Sharapova, Marc Andreessen, Neil Gaiman, Neil de Grasse Tyson, Jocko Willink, Daniel Ek, Kelly Slater, Dr. Peter Attia, Seth Godin, Howard Marks, Dr. Brené Brown, Eric Schmidt, Michael Lewis, Joe Gebbia, Michael Pollan, Dr. Jordan Peterson, Vince Vaughn, Brian Koppelman, Ramit Sethi, Dax Shepard, Tony Robbins, Jim Dethmer, Dan Harris, Ray Dalio, Naval Ravikant, Vitalik Buterin, Elizabeth Lesser, Amanda Palmer, Katie Haun, Sir Richard Branson, Chuck Palahniuk, Arianna Huffington, Reid Hoffman, Bill Burr, Whitney Cummings, Rick Rubin, Dr. Vivek Murthy, Darren Aronofsky, Margaret Atwood, Mark Zuckerberg, Peter Thiel, Dr. Gabor Maté, Anne Lamott, Sarah Silverman, Dr. Andrew Huberman, and many more.DISCLAIMER: I'm not a doctor, nor do I play one on the Internet. 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MICHAEL It's Friday, so that can only mean one thing: it's Five in the Eye day! This is me - Michael Ohajuru - welcoming you to episode 0388 of Colourful Radio's weekly news review show. PHIL And this is Phil Woodford joining Michael via Zoom and revealing that our top story is going to be the wave of strikes that are hitting us this month. The train workers have been joined by ambulance crews, nurses, teachers and posties among others, making this Christmas one of real industrial strife. MICHAEL And for story number two, it's a topic close to my own heart. I've actually taken the drug Pregabalin for shoulder pain. So it was shocking to see the recent report on Channel 4 News about the addictive quality of the drug. There is even debate over whether doctors should prescribe it all. PHIL And it's our World Cup slot at story number three, where Anthony - our football correspondent - will join us again. He's sadly lost his bet on Japan going all the way. So what are his predictions now? MICHAEL What's story number four? Well it's the Just Eat delivery agents who have been going above and beyond the call of duty to deliver McDonald's to Scottish doorsteps. There's a branch of the fast-food chain in Grangemouth that insists on them scaling a five-foot fence to grab Big Macs. PHIL And finally, to wrap up the show, let's hope we don't go into Goblin mode, which is the Oxford word of 2022. It apparently means “a type of behaviour which is unapologetically self-indulgent, lazy, slovenly, or greedy, typically in a way that rejects social norms or expectations”. MICHAEL Never on this show! And that's this week's Five in the Eye! ++++

The stories continue from my time on the psych ward, this time focusing on my current and very real problem of withdrawals. It is hard enough when your brain wants to play tricks on you but even more challenging when medications used in the past are actually found to be part of the problem. And it isn't as simple as just stopping dosages, oh no!

Dr. Ebell and Dr. Wilkes discuss the POEM titled ' Amitriptyline, duloxetine, and pregabalin each effective in decreasing pain from diabetic peripheral neuropathy; combinations even better '

Thank you Chase Zaremba, OMS III and Brandon Brown, OMS III for developing this podcast. This podcast identifies medications (Duloxetine, Carbamazepine, Amitriptyline, Pregabalin, Milnacipran and Gabapentin) and a therapy (CBT) that often are associated with psychiatry and the indications for use in treatment of pain. There is a surprising amount of moderate yield information spread throughout. We enjoyed our discussion and hope you find it as interesting as we did! Thank you Jordan Turner for creating the perfect bumper music!

Hören statt Lesen: Chefredakteurin Julia Pflegel hat den Artikel zum Wirkstoff Pregabalin aus unserer Serie Fresh-up vertont. Hören Sie gleich mal rein! (6:27 Min) https://www.das-pta-magazin.de/serie-fresh-up-pregabalin-3121211.html

In this week's episode of the Spine & Nerve podcast Dr. Nicolas Karvelas and Dr. Brian Joves discuss Post Herpetic Neuralgia (PHN), the most common complication of Herpes Zoster (also known as Shingles, which is caused by reactivation of the Varicella Zoster Virus). PHN is defined by pain that is typically burning or electrical, and may be associated with allodynia or hyperesthesia in a dermatomal distribution. Pain from PHN is typically sustained for at least 90 days after the rash. PHN is caused by nerve injury due to the inflammatory response induced by viral replication within the nerve. Epidemiologic studies have found that PHN occurs in about 20% of patients who have Herpes Zoster. With the relatively recent development of the preventative vaccine Shingrix (which has been found to be 97% effective in preventing Herpes Zoster) it is anticipated that the total prevalence of Herpes Zoster and PHN will decrease. However, research has repeatedly demonstrated that immunocompromised patients are at a significantly increased risk for Herpes Zoster and PHN (20-100 times increased risk of development of PHN). As of today, the Advisory Committee on Immunization Practices has not cleared immunocompromised patients to receive the Shingrex (or Zostavax) vaccine; therefore for multiple reasons PHN will most likely continue to be a prevalent diagnosis. Treatment options for PHN include physical modalities (TENS, desensitization), topical medications (including Lidocaine 5% patch, and Capsaicin), oral medications (including Gabapentin, Pregabalin, Tricyclic Antidepressants), and procedures. Listen as the doctors review Herpes Zoster, PHN, and a recent research article evaluating the effect of the Erector Spinae Plane Block in regards to prevention of PHN once Herpes Zoster has already developed. This podcast is for information and educational purposes only, it is not meant to be medical or career advice. If anything discussed may pertain to you, please seek counsel with your healthcare provider. The views expressed are those of the individuals expressing them, they may not represent the views of Spine & Nerve. References: 1. Zeng-Mao Lin, MD, Hai-Feng Wang, MD, Feng Zhang, MD, Jia-Hui Ma, MD, PhD, Ni Yan, RN, and Xiu-Fen Liu, MD. The Effect of Erector Spinae Plane Blockade on Prevention of Postherpetic Neuralgia in Elderly Patients: A Randomized Double-blind Placebo-controlled Trial. 2021;24;E1109-E1118. 2. Dooling KL, Guo A, Patel M, et al. Recommendations of the Advisory Committee on Immunization Practices for Use of Herpes Zoster Vaccines. MMWR Morb Mortal Wkly Rep 2018;67:103–108.

Kurz und knackig geht es heute um Pregabalin, auch unter dem Handelsnamen Lyrika bekannt, Gabapentin und die Generika dieser Medikamente. Der missbräuchliche Konsum von Pregabalin und Gabapentin ist nocht nicht sehr erforscht. Wenn man nach Informationen sucht, findet man auf den ersten Blick nur ein paar Informationen zu den Medikamenten und nur kleine Hinweise darauf, dass sowohl ein missbräuchlicher Konsum als auch eine Entwicklung einer Abhängigkeitserkrankung möglich sind. Taucht man jedoch tiefer in das Thema ein wird dies immer deutlicher. In dieser Folge lernt ihr alles Grundlegende, was man zu Pregabalin und Gabapentin wissen muss. Wir schauen uns sowohl erwünschte als auch unerwünschte Wirkungen an. Aber auch wie lange Pregabalin im Urin nachweisbar ist, wird aus einer Quelle hergeleitet. Vorallem den Aspekt des Missbrauchs und der Abhängigkeitsentwicklung wird hierbei besonders genau unter die Lupe genommen - zumindest das, was man aus den sperlichen Quellen herausziehen konnte. _____________________________________ Instagram: https://www.instagram.com/psychoaktiv.podcast/ Twitter: https://twitter.com/psychoaktivcast Facebook: https://www.facebook.com/psychoaktiv.podcast

Drs Heather Bell & Kurt DeVine continue the series on drugs felt to be safe…. But are not necessarily! In Episode #11 of “Safe Drugs- or Not” we discuss pregabalin aka Lyrica- a medication first approved for fibromyalgia!  Felt to be a safer alternative to gabapentin, it has actually shown to have many ‘issues' of its own…. To learn more about the doctors as well as keep up with current happenings follow us on twitter: @echocsct and Facebook: @theaddictionconnectionhk

Drs Heather Bell & Kurt DeVine continue the series on drugs felt to be safe…. But are not necessarily! In Episode #11 of “Safe Drugs- or Not” we discuss pregabalin aka Lyrica- a medication first approved for fibromyalgia!  Felt to be a safer alternative to gabapentin, it has actually shown to have many ‘issues' of its own…. To learn more about the doctors as well as keep up with current happenings follow us on twitter: @echocsct and Facebook: @theaddictionconnectionhk

Andrew Pierce speaks to PR guru Mark Borkowski on why Boris's battle against former chief of staff Dominic Cummings is a no-win scenario, and talks to Redress legal advisor Charlie Loudon on his battle to free Nazanin Zaghari-Ratcliffe. Plus, Miranda Levy on her struggle to stop using anti-anxiety drug Pregabalin after a doctor prescribed it for insomnia. See omnystudio.com/listener for privacy information.

At the back end of last year Ollie asked me to help him with his own podcast (which will be linked as soon as it's officially up and running!). We filmed this episode for his podcast as kind of a test run and he's kindly said I could upload the episode to the WhatMS channel also. Its basically just story time, and I kinda cover a bit more in depth what went on in my life over the last couple of years. I also dicuss my time in a rehab facility, and my experiences withdrawing from the drug Pregabalin (also known by the brand name Lyrica). All of the content I put out is/are my own PERSONAL experience(s), and I am also aware that the drug in question is also helpful in some cases. I have previously been reluctant to share details about what I went through with it, but the reality is it happened to me - therefore I am now choosing to share, as I know there are people that have been through it too. A massive thank you to Ollie for having me, and listening to my waffle :) Find us on social media - @WhatMS_ @olatherton @deadliftsarebae

E quindi che cos’è concretamente il disturbo d’ansia generalizzato? E, soprattutto, quali sono gli strumenti terapeutici per curarlo appropriatamente? Bene, come vi ho detto se seguirete questo video sino alla fine vedrete che otterrete la risposta ad entrambe queste domande.Il Disturbo d'Ansia Generalizzata è il più comune e diffuso disturbo d'ansia, infatti colpisce il 3-5% della popolazione e interessa prevalentemente le donne (1,5:1). In questo video vi parlerò delle caratteristiche del Disturbo d'Ansia Generalizzata (GAD, dall'inglese "Generalized Anxiety Disorder") e delle metodiche di trattamento più efficaci e moderne.Quindi parlerò di CBT (psicoterapia cognitivo comportamentale), Antidepressivi SSRI e TC (triciclici), farmaci anticonvulsivanti come il gabapentin ed il pregabalin.#ansia #GAD #DAGISCRIVETEVI AL MIO CANALE ► https://bit.ly/2zGIJorVi interessano la Psichiatria e le Neuroscienze? Bene, allora iscrivetevi a questo podcast, al mio canale YouTube e seguitemi sul web tramite il mio blog https://www.valeriorosso.comInoltre andate su Amazon a dare un’occhiata ai miei libri:“Psicobiotica” - Un nuovo modo di intendere il rapporto tra la Mente ed il Corpo….andate su: https://amzn.to/2IZwjhm“Psichiatria Rock” - 50 pensieri off line dal mio blog….andate su: https://amzn.to/2IVKKmJIl Dr. Valerio Rosso, su questo canale YouTube, si dedica a produrre delle brevi lezioni di psichiatria rivolte ai pazienti, agli operatori della salute mentale, a famigliari di pazienti ed a chiunque sia interessato alla psichiatria ed alle neuroscienze.

Welcome to the eighth edition of my sciatica newsletter!This week’s podcastIn this week’s podcast, I talk to Michelle Angus. Michelle is a consultant physiotherapist working for the Complex Spinal Team in the Emergency Village of a tertiary spinal referral centre at Salford Royal NHS Foundation Trust. In this podcast, she tells me about:Managing radicular pain in the EDSpinal injectionsSpinal surgeryMedications for radicular painAnd much more!So long, gabapentinoids?In the podcast, Michelle shares her clinical experience with prescribing gabapentinoids to people with acute radicular pain. Her impression is that while they do not work for everybody, some of her patients get meaningful relief. In last week's podcast, Kate told me that gabapentin helped her own radicular pain. When I asked on twitter, I heard (mostly) similar stories: "gabapentinoids are sometimes the only thing that allows my patients/allowed me to get any relief". At the time of writing, NICE guidelines for sciatica don’t make a specific recommendation on gabapentinoids; instead, they direct the reader to the general guidelines for prescribing for neuropathic pain, which approve them. But, the draft version of the updated NICE guidelines for low back pain and sciatica (released some weeks after my conversation with Michelle) recommends against them. According to the draft update, there is no evidence to support their use for people with sciatica.Where do we go from here?Gabapentin was developed in the early 1970s. It was approved in 1993 for seizures and marketed for pain soon after. Pregabalin arrived on the scene about ten years later. In the last two decades, their use has increased dramatically. Much of this has been “off label”, and the drugs have nontrivial side effects, so this increase is a cause for concern. (Graph taken from Montastruc et al.)Together we can call gabapentin and pregabalin gabapentinoids or anti-epileptics. Sometimes the term "anti-neuropathics" is used to bundle the gabapentinoids with tricyclic antidepressants like amitriptyline. The gabapentinoids were designed to work on GABA, an inhibitory neurotransmitter, which is where they get their name. It turns out they don't do this. Instead, it seems they primarily work on voltage gated calcium channels. You will remember that when an action potential arrives at the axon terminal, voltage gated calcium channels open to let calcium into the neuron. The calcium causes this first neuron to release neurotransmitters into the synapse, which trigger another action potential in the second neuron. After a nerve injury, more voltage gated calcium channels are expressed on the end of the injured first neuron, so more neurotransmitter is released, so the second neuron becomes more excitable, which can increase pain. These voltage gated calcium channels are made up of smaller sub-structures, one of which is the α2δ subunit. It's this subunit that the gabapentinoids act on. As far as I can tell, we don't know exactly how. One theory is that gabapentinoids stop the subunits from being transported to the axon terminal in the first place. With fewer α2δ subunits, one link is weakened in the chain of synaptic transmission. And so that second neuron is less excitable. There is a good deal of evidence that gabapentinoids work fairly well for neuropathic pain. The problem is, we can’t say the same for sciatica. The draft update to the NICE guidelines refers to only three studies. One is small, lower quality and found gabapentinoids worked quite well. The other two are large, high-quality trials, and say gabapentinoids are no better than placebo. On reading that these large, high quality studies found no benefit, my first question was: Did they select patients with *neuropathic* radicular pain? After all, radicular pain is a very mixed bag of nociceptive, inflammatory and 'nociplastic' mechanisms, to name just a few. But I would only expect gabapentin to be effective for the subgroup of people with neuropathic pain, meaning actually damaged, not just irritated, nerves. People with severe shooting pain, numbness, pins and needles, etc. If the trials jumbled up these people with all the other mechanisms of back and leg pain, then no wonder their results are negative. Picture from Schmid, Fundaun and Tampin (2020)At first glance, it seems like these studies did indeed jumble up the different pain mechanisms. In the trial by Mathieson et al., only a third of patients had likely neuropathic pain (as measured by questionnaire) and half had no loss of sensation (which indicates true nerve damage). And the other trial, by Baron et al., didn't give enough detail on the patients to say whether or not they had neuropathic pain, which implies they too were a mixed group. But on closer inspection, both studies did account somewhat for mechanism-based prescribing. Mathieson et al. did a post-hoc analysis to see if patients with neuropathic pain benefited more. There was no evidence they did. And Baron et al. did try and target patients by giving them a mini pre-trial to see if they were "responders" to pregabalin before enrolling them in the main trial. In the main trial, this group of "responders" didn no better with pregabalin than placebo.Besides, even if there is a subgroup of neuropathic-pain "responders" hidden in these two trials, for the trials to show a null result there would have to be an equal but opposite group of people who got worse taking the drugs!Where does this leave us? The way I see it, there are four positions:1. "Gabapentinoids don't work for radicular pain". People are saying this more and more, and it is probably true in most cases. But, it has a ring of certainty that is not supported by the evidence. (This is a soap box of mine, but I think we need to stop being so cavalier in saying "X doesn't work for Y"; most clinical trials aren't able to tell us this).2. "There is no research evidence to support the use of gabapentinoids for radicular pain, and good evidence to show they are not better than placebo when prescribed according to common practice. Although anecdotally they seem to work for some people, we have no way of knowing whom, so we shouldn't risk it". This seems reasonable to me, especially considering the harms of these drugs, which I have not covered in this newsletter. If we have no way of knowing whether and how often we are doing something right, how can we justify doing it? Better to just cut it out until we can figure out a better way (researchers are currently working on "sensory profiling" to target prescribing for anti-neuropathics).3. "There is no research evidence to support gabapentinoids for radicular pain, and good evidence to show they are not better than placebo when prescribed to a heterogenous group. So, we should prescribe them sparingly and cautiously, and only in people who have severe neuropathic radicular pain". This seems reasonable to me too! We shouldn’t limit ourselves to research that is of limited pertinence to our clinical problem just because it's the only research that exists (as in the fable of the drunk who has lost his keys and looks under a lamp post because it's the only spot that's illuminated).4. "Gabapentinoids work for radicular pain". It goes without saying, this statement unjustifiable.How to choose between (2) and (3) is tough. Luckily, I don't prescribe, so I don't have to make these difficult decisions myself! But I do have to make decisions about whether to refer people to clinicians who do prescribe. At the moment (possible guideline change notwithstanding), I would refer for consideration of gabapentinoids rarely and only in the following conditions:Severe, acute, disabling radicular painNeuropathic pain, preferably as measured by questionnaire (although these are not really well validated: a topic for another newsletter)No option of epidural steroid injection any time soon Either the clinician or the patient has a good relationship with the prescriberThe patient is in a service where they will get continuity of care and support with tapering if neededAs ever, I’d be really keen to hear your views, particularly disagreements and corrections. Other bits and bobsWho should I talk to for future episodes of the sciatica podcast? I have already had some good suggestions on twitter. As a reminder, I’d also like to talk to people who have experienced radicular pain or clinicians with interesting case studies. The transcript of my podcast with David Butler is now available. Honestly, this was a huge ball-ache to write up, so I will see how useful it is to people before doing another one. I think at the moment it’s a bit odd that the podcast and the newsletter arrive in the same email, so in the future I might put the podcast out midweek instead…There was no newsletter last week as I was in Big Sur, celebrating my birthday and enjoying the return of the NBA :)  Big Sur view With my niece, baby Ellie. Subscribe at tomjesson.substack.com

See all the Healthcast at https://www.biobalancehealth.com/healthcast-blog/ Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain processes pain signals. Fibromyalgia is a disease that presents with severe fatigue, poor quality of life, and pain and sensitivity in the muscles (not joints) that make a patient so tender that they can't stand to be touched.  Main signs and symptoms fatigue-severe lack of energy. trouble sleeping. depression or anxiety. memory problems and trouble concentrating (sometimes called “fibro fog”)   muscle twitches or cramps. numbness or tingling in the hands and feet. Itching and burning of the skin 40-70 % of people with Fibromyalgia also have GI symptoms like irritable bowel, bloating gas and nausea that comes and goes.  70% of Fibromyalgia patients have tension and migraine headaches. Many of these  symptoms overlap with several other illnesses such as Chronic Fatigue ( a low cortisol condition) that can follow a viral illness, as well as some autoimmune diseases, and the symptoms of  low testosterone and low growth hormone,  Like autoimmune diseases, fibromyalgia occurs in women more than men, and women over 40 more than younger women. When diagnosing Fibromyalgia, we must rule out autoimmune diseases, Lyme disease, and other chronic viral infections, and diseases such as depression.  Previously we just ruled out other diseases and put our fibromyalgia patients on an antidepressant for both the depression symptoms and the to relieve the pain.  Fibromyalgia is a disease of low serotonin levels, so the antidepressant isn't just for the mood portion of the disease but also to relieve pain. Because we now know more about Fibromyalgia, we have found that there is usually an incident that caused severe chronic stress that de-regulated the hormones and neurotransmitters in the patient's brain that later caused her to have fibromyalgia at a later date. Chronic stress, like being abandoned as a child, or being abused at any age, severe illness including lyme disease, mononucleosis, PTSD, or any other lifestyle choice like drug use, or practicing obstetrics or ER medicine, that stresses the body. The result of this stress results in chronic elevated cortisol and adrenaline. This wears out the brain and the adrenal gland and the patient can't respond to stress of any kind anymore.  Even being stroked gently feels like pain. In The Journal of International Immunopharmacology, 2 March 2015, the article, A novel use for Testosterone to treat central sensitization of chronic pain in fibromyalgia patients, discusses the association of low T and the incidence of Fibromyalgia.  Low estradiol, low testosterone and low GH all occur when a patient has FBM.  When these hormones are brought back to normal by replacing them, the symptoms go away!  I have seen this many times and sleep, pain and pain all become normal as long as we can replace T and E2, an stimulate GH with somatotropin. Other treatments include anti-inflammatory medications like Celebrex or NSAIDS, SSRIs, Pregabalin, sometimes low dose steroids, Testosterone, GH stimulation in both sexes plus Estradiol in women.  These are the treatments we employ when treating Fibromyalgia, and we watch all the symptoms of fibromyalgia go away when we start with T, E2, oral pregnenolone and GH stimulation.  After that, we use the other, non-medical methods of treating Fibromyalgia. The non-medical methods include: Set sleep hours at least 8 hours a night every night Dark sleeping environment Mediterranean low carb diet avoiding preservatives and chemicals in your food. Progressive exercise Nutritional supplementation Meditation and relaxation exercises   Nutritional Supplementation with: Vitamin D3, K2 and zinc piccolate Endodren adrenal supplement q am Lipo C vitamin Fish oil and flaxseed oil Methyl B vitamin Magnesium Glycinate 40 mg BID L arginine GABA SamE 400mg three times a day Cucumin 800 mg three times a day All of these are treatments for FB but the basis of treatment and the most effective is Bio-identical T pellets and E2 pellets + injectable sq sermorelin/ CJC to stimulate growth hormone. Everything else is in addition to the hormone replacement. The reason no one seems to have an answer for  those of you who have FB  “lies in the combination of knowledge  (needed to diagnose and treat FB) from diverse fields including reproductive endocrinology related to the gonadal steroid hormones (estradiol, testosterone), nociception, neuro-endocrinology and reproductive immunology.” HD White, TD Robinson, International Immunopharmacology 27 (2015) 244-248. It is for the very same reason that mainstream medicine has not yet acknowledged the amazing power of testosterone in the non-oral subcutaneous delivery system.  It crosses the fields of OBGYN, Urology, Endocrinology, Rheumatology, Neurology, Psychiatry and immunology to see the many ways in which the replacement of Bio-identical T and E2 can treat many illnesses that we are currently using dangerous and ineffective drugs for.  Testosterone loss is the first shoe to drop in the loss of homeostasis as we age,  and the advent of multiple diseases that we still don't know how to treat because we are too segmented in our specialties….no experts read the research of  another specialty  which is the arrogance of the specialists.. in the end we all lose because we only read the papers of what we already know!  Until we humble ourselves to read ALL research about diseases we don't know how to treat, we will never get the proper treatment for our patients.  This is my mission, and my goal…but no one in the many fields that are necessary to understand the many uses of testosterone and estradiol and how to safely treat our patients, so they NO LONGER have the diseases triggered by loss of the sex hormones.

Doctors in regional Australia say pain medication pregabalin is often prescribed as a stop gap when patients cannot access pain specialists.

It's linked to depression and anxiety, and is now the top pain medication on the PBS.

In this episode I cover neuropathic pain.If you want to follow along with written notes on neuropathic pain go to https://zerotofinals.com/medicine/neurology/neuropathicpain/ or the neurology section in the Zero to Finals medicine book.This episode covers presentation, diagnosis and management of neuropathic pain. I also discuss complex regional pain syndrome.The audio in the episode was expertly edited by Harry Watchman.

Listen to an audio podcast of the December 19, 2019 FDA Drug Safety Communication warning that serious breathing difficulties may occur in patients using seizure and nerve pain medicines gabapentin (Neurontin, Gralise, Horizant) and pregabalin (Lyrica, Lyrica CR) who have respiratory risk factors.

The gabapentinoids are a popular class of medications among prescribers for use in chronic pain and various other neurological conditions. In fact, prescription rates for both gabapentin and pregabalin have increased in the United States and other countries in recent years. However, these medications have a street value to a newer niche of users, including patients taking them at mega doses to enhance the effects of other psychotropic drugs, and others taking them to manage or mitigate opioid withdrawal symptoms and possibly even opioid cravings. While pregabalin is already classified as a controlled substance, gabapentin does not yet carry this classification in most states. In response to rising abuse, various states and regulatory bodies are considering changes to enhance patient safety and protect the provider’s license. Learn what changes you should make to your practice, if any, in light of the growing abuse of gabapentinoids and how to identify patients who are potentially abusing these medications. (Recorded at PAINWeek 2018)

The gabapentinoids are a class of drugs vaguely resembling the neurotransmitter GABA. Although they were developed to imitate GABA’s action, later research discovered they acted on a different target, the A2D subunit of calcium channels. Two gabapentinoids are approved by the FDA: gabapentin (Neurontin®) and pregabalin (Lyrica®). Gabapentin has been generic since 2004. It’s commonly used for seizures, nerve pain, alcoholism, drug addiction, itching, restless legs, sleep disorders, and anxiety. It has an unusually wide dose range: guidelines suggest using anywhere between 100 mg and 3600 mg daily. Most doctors (including me) use it at the low end, where it’s pretty subtle (read: doesn’t usually work). At the high end, it can cause sedation, confusion, dependence, and addiction. I haven’t had much luck finding patients a dose that works well but doesn’t have these side effects, which is why I don’t use gabapentin much. Pregabalin officially went generic last month, but isn’t available yet in generic form, so you’ll have to pay Pfizer $500 a month. On the face of things, pregabalin seems like another Big Pharma ploy to extend patents. The gabapentin patent was running out, so Pfizer synthesized a related molecule that did the same thing, hyped it up as the hot new thing, and charged 50x what gabapentin cost. This kind of thing is endemic in health care and should always be the default hypothesis. And a lot of scientists have analyzed pregabalin and said it’s definitely just doing the same thing gabapentin is. But some of my anxiety patients swear by pregabalin. They call it a miracle drug. They can’t stop talking about how great it is. I can’t use it too often, because of the price, but I’m really excited about the upcoming generic version coming out so I can use it more often.

Pregabalin is an analgesic agent which has attracted some adverse publicity recently. Prof David Scott discusses the appropriate use of this non-opioid analgesic agent.

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Dive deep into the psychopharmacology of depression with Dr Patrick Finley, PharmD at UCSF. Learn practical tips including how to switch from one antidepressant to another, what to expect with SSRI and SNRI withdrawal, and how to choose a second (or third) antidepressant for refractory depression. We also summarize the safety around antidepressants in the peripartum period. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST). Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by: Molly Heublein, MD CME questions by: Molly Heublein, MD Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD, Molly Heublein, MD Edited by: Matthew Watto MD Guest Presenter: Patrick Finley, PharmD BCPP Sponsor Check out the ACP's Medical Knowledge Self Assessment Program, MKSAP 18. Time Stamps 00:00 Sponsor ACP’s MKSAP 18 00:25 Disclaimer, intro and guest bio 04:33 Guest one-liner, book recommendation, and first patient complaint 08:04 Picks of the week 12:10 Sponsor ACP’s MKSAP 18 14:03 Clinical case of depression; assessing target symtpoms to characterize depression; choice of initial SSRI 17:49 Discussion of iron, ferritin, folate and L methylfolate as they relate to treatment refractory depression 20:12 Postpartum depression, iron, genetics and environmental factors 22:35 How to switch from one SSRI to another; Cross-titration from SNRI to SSRI or from SSRI to SNRI 26:05 Withdrawal symptoms from SSRIs or SNRIs and a bit more on switching and cross titration 31:33 Is paroxetine ever a good idea? 33:03 Ultra-rapid metabolizers of SSRIs and pharmacogenomics 34:43 Postpartum depression and treatment with antidepressants during pregnancy and lactation 39:25 Monitoring response to therapy with antidepressants ie PHQ-9 40:53 Augmentation for partial response; bupropion for augmentation and sexual side effects; 43:58 Counseling patients about discontinuation of therapy 47:00 How to choose an agent for augmentation of antidepressant therapy 51:02 Mirtazapine 52:41 Vortioxetine 53:24 Atypical antipsychotics for augmentation 55:37 Pregabalin and gabapentin for augmentation 57:42 Dr Finley’s take home points 60:48 Outro

Sciatica is a form of neuropathic pain which can be particularly frustrating for patients and difficult to manage. With a lack of evidence to guide treatment and opioid use becoming increasingly under the microscope, data supporting the use of alternative pain regimens are needed. Gabapentin and pregablin are GABA analogs often used to treat sciatic pain, but is one superior to the other? Pregabalin is newer and available as a branded product only, but is it more effective than generically available gabapentin?  A recently published study attempts to answer this question. Guest Authors:  Austin Morgan, PharmD and Frank Fanizza, PharmD Music by Good Talk

Journal Club Express this week focuses upon a piece in Anesthesiology; Cognitive Effects of Perioperative Pregabalin: Secondary Exploratory Analysis of a Randomized Placebo-controlled Study. Link here: http://anesthesiology.pubs.asahq.org/article.aspx?articleid=2708941  

In this episode we discuss: Dr. Gilbert Welch's Wikipedia page and how we should keep his decades of work in perspective, a Twitter conversation between experts on differing interpretations of results from next-generation sequencing, the new paper in JAMA titled "Assessment of Pregabalin Postapproval Trials and the Suggestion of Efficacy for New Indications", and finally, along with Dr. Sam Edwards of OHSU, we criticize the recent perspective piece in NEJM titled "Beyond Evidence-Based Medicine". Welch's Wikipedia: https://en.wikipedia.org/wiki/H._Gilbert_Welch Pregabalin: doi.org/10.1001/jamainternmed.2018.5705 Beyond EBM: doi.org/10.1056/NEJMp1806984 We have also launched our Patreon page! Become a patron at https://www.patreon.com/plenarysession.

Tales of good and bad experiences with psychiatric medication, Lithium, Lamotrigine, Pregabalin, Abilify, Latuda, Risperidone,...

On today's episode, I breakdown the pharmacology of gabapentin and pregabalin and what you will see in clinical practice.  These drugs are most often utilized for pain syndromes.  I cover adverse effects, drug interactions, drug/disease interactions, mechanism of action in this episode.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers the treatment of generalized anxiety disorder with Dr. Jared Peck, a Staff Psychiatrist at Mount Sinai Hospital in Toronto. In this episode, Jordan Bawks (PGY2 resident) and Bruce Fage (PGY4 resident) reunite with Dr. Peck to talk about the bio-psycho-social management of GAD. They cover recommended lifestyle changes for people with GAD, evidence-based pharmacotherapies, including SSRIs, SNRIs, Pregabalin, Quetiapine, TCAs and benzodiazepines, and how to choose between them, and psychotherapeutic treatments with a focus on CBT and a quick overview of some of the third wave cognitive models. By the end of this episode, the listener will be able to… List the lifestyle changes recommended for people with GAD Describe the first line and second line medication therapies for GAD and the rationale supporting each agent's place in the treatment hierarchy  Appreciate the key elements of CBT that make it effective for the treatment of GAD Relevant Articles: Generoso et al., 2017 (Pregabalin for GAD metaanalysis) Katzman et al., 2014 (Canadian Anxiety Guidelines) Perrin et al., 2019 (Laval model) Please Note: The views expressed in this podcast do not necessarily reflect those of the Canadian Psychiatric Association or the University of Toronto and are not meant to replace formal clinical education or judgment. For more PsychEd, follow us on Twitter (@psychedpodcast) and Facebook. You can provide feedback by email at psychedpodcast@gmail.com For more information visit our website: psychedpodcast.org.

When a new drug reaches market, the race is on to find more indications for its use - exploratory trials are set up, and positive results can lead to the off label prescriptions (eg Pregabalin for lower back pain. However, these initial indications are rarely confirmed with further, better quality, evidence. Jonathan Kimmelman is an associate professor at MCgill University in Canada, thinks it's time to explore less, and confirm more - and joins us to explain why. Read the full analysis: http://www.bmj.com/content/360/bmj.k959

Dr. Christopher Goodman is an assistant professor of clinical internal medicine at the University of South Carolina School of Medicine. Stephen Morrissey, the interviewer, is the Managing Editor of the Journal. C.W. Goodman and A.S. Brett. Gabapentin and Pregabalin for Pain - Is Increased Prescribing a Cause for Concern? N Engl J Med 2017;377:411-4.

Listen to Episode 16 of the ACA Podcast: Trial of Pregabalin for Acute and Chronic Sciatica, presented by Dr Anthony Coxon, with special guest Dr Stephanie Matheison.

Migraine is a common presentation to primary care clinics. Current pharmacologic treatments offered by physicians have notable side effects and may be a financial burden. Understandably, patients are looking to alternative therapies. However, primary care providers may not be able to provide an educated opinion about whether these therapies are reasonable to pursue. Fraser provides ... The post Keep Calm and Get Your Analgesic On: Acupuncture for Migraine Prophylaxis and Pregabalin for Sciatica appeared first on Healthy Debate.

Migraine is a common presentation to primary care clinics. Current pharmacologic treatments offered by physicians have notable side effects and may be a financial burden. Understandably, patients are looking to alternative therapies. However, primary care providers may not be able to provide an educated opinion about whether these therapies are reasonable to pursue. Fraser provides ...The post Keep Calm and Get Your Analgesic On: Acupuncture for Migraine Prophylaxis and Pregabalin for Sciatica appeared first on Healthy Debate.

Prescriptions for nerve drugs pregabalin and gabapentin have risen dramatically in recent years and at the same time, concerns about abuse. Former prisoner and addict "Patrick" tells Dr Mark Porter that "gabbies" or "pregabs" are drugs of choice in jail and Dr Iain Brew, a GP who works in prisons, says misuse is a growing problem and there are examples of doctors being pressurised into prescribing them. Dr Cathy Stannard, consultant in pain medicine at Southmead Hospital in Bristol, chaired an expert group that drew up new prescribing guidelines for pregabalin and gabapentin and she tells Mark that more attention needs to be paid to emerging evidence of misuse. Many women say that if they've had one caesarean section, they feel pressurised to have another one and Sara describes how her medical team planted "a seed of doubt" about the potential risks to her baby which she says for her meant another C-Section was inevitable. But new guidelines from the Royal College of Obstetricians and Gynaecologists spell out that vaginal birth after a previous caesarean is a clinically safe choice, with a 75% success rate, the same as for first-time mothers. Inside Health's Dr Margaret McCartney discusses the history of changing attitudes to natural birth after caesarean and says why the new guidelines should give future mothers the confidence to discuss, well in advance of their birth, the best option for them. How do you fill in health check forms that ask for family history if you don't know who your family was? Inside Health listener Jessica is adopted and her heart health check suggested a very low risk of a stroke or heart attack when she couldn't answer the family history question. Mark and Margaret discuss how common this is, and what difference family knowledge would make to Jessica's risk (not much). Adrenaline auto injectors were first used in the 1960s when they were developed for soldiers to use during nerve gas attacks allowing them to self administer the antidote. But is a device designed to be used by fit, trained soldiers just as suitable for use in children and adults of widely varying size and weight? These concerns were raised by a coroner conducting the inquest into the death of a 19 year old student who died of anaphylactic shock caused by a nut allergy, despite her using her auto injector. The Medicine and Healthcare Products Regulatory Authority and also the European Medicines Agency have been looking into issue and Dr Robert Boyle, allergy specialist at St Mary's Hospital, Paddington and Director of the Paediatric Research Unit at Imperial College, London provided expert advice. He talks to Mark about the limitations of auto injector design and urges everybody who might use the devices to ensure they are confident about exactly how to use them.

A review of the work up and management of Complex Regional Pain Syndrome   References Yaguda B, Shekane P, Gharibo C.  Complex Regional Pain Syndrome: Pathophysiology, Diagnosis and Treatment.  Pain Medicine News.  Vol 12, Number 10. Dec. 2014   Veldman PH, Reyen HM, Arntz IE, et al. Signs and Symptoms of reflex sympathetic dystrophy: prosepective study of 829 patients. Lancet. 1993; 342 (8873): 1012-1016   Borchers AT, Gershwin ME. Complex Regional Pain Syndrome: a comprehensive and critical review. Automimmun Rev. 2014;13(3):242-265   DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment.  You should regularly consult a physician in matters relating to yours or another's health.  You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional.  Copyright © 2015 David Rosenblum All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.  

As with many anticonvulsants, pregabalin is enjoying an ever increasing spectrum of use. Originally licensed for the treatment of epilepsy, diabetic neuropathic pain and post-herpetic neuralgia; pregabalin has become a staple of the chronic pain armamentarium. To date, well over 100 studies have explored pregabalin's use in the perioperative period on a diverse range of symptoms including acute pain and preoperative anxiety. This issue of the BJA carries a meta-analysis looking at the utility and prescribing rationale for pregabalin in the peri-operative period. In this podcast Dr Ashraf Habib from Duke University Medical Centre takes us through the potentially practice changing evidence for pregabalin use in the perioperative period.

A monthly audio round-up detailing the contents of the latest issue of DTB.Articles:Patient safety first? DTB 2010; 48: 13Management of community-associated MRSA DTB 2010; 48: 14 - 19▼Pregabalin for generalised anxiety disorder DTB 2010; 48: 19 - 22A change of units for HbA1c DTB 2010; 48: 23 - 24Conversion chart for HbA1c values