Lyrica, or pregabalin, is both an analgesic---pain-relieving---medication and an anti-convulsant medication. The medical reference UpToDate reports that Lyrica is used to treat several types of pain: pain in the arms and legs caused by nerve damage in diabetes; nerve pain that may result from the herpes zoster virus; and the tender "trigger points" associated with fibromyalgia. It is also used as a supplemental therapy in patients with some types of epilepsy. Lyrica does all this by inhibiting a variety of neurotransmitters---chemical substances that relay a nerve impulse from one nerve to another.
Possible Mechanism of Action of Lyrica
While the exact mechanism of action is not yet known, the Lyrica product website suggests that one of the methods in which Lyrica may work is by binding to part of the cell structure called a calcium channel. This changes the amount of calcium that can enter the calcium channel and in turn may impact the release of two neurotransmitters. The neurotransmitters affected by this calcium channel binding are related to the experience of pain.
Glutamate
One of the neurotransmitters affected by Lyrica is called glutamate. Glutamate is what is known as an "excitatory" neurotransmitter---as the name suggests, it "excites" nerves and causes nerve impulses to continue transmitting from one nerve to another. Both the Lyrica website and the pharmacology reference MicroMedex suggest that reducing, or inhibiting, the amount of glutamate that can be released may be part of the way Lyrica decreases nerve pain.
Substance P
In a 2005 paper published in the journal "Molecular Pain." Dr. L.J. Wu, of the University of Toronto, and his colleagues explain that substance P, sometimes abbreviated SP, is a neurotransmitter that plays an important role in the transmission of pain signals along the spinal cord. One of the possible ways in which Lyrica works as a pain-relieving agent is that by binding to the calcium channel, the amount of substance P that is released is decreased. If less substance P is released, the message of "pain" will not be sent from the spinal cord to the brain, and patients will feel that their pain is reduced.
References
- Lyrica (Pregabalin Capsules) Proposed Mechanism of Action
- "Molecular Pain"; Feed-Forward Inhibition: A Novel Cellular Mechanism for the Analgesic Effect of Substance P; L.J. Wu et al.; November 2005
- MicroMedex: Pregabalin
