ProHealth health Vitamin and Natural Supplement Store and Health
Home  |  Log In  |  My Account  |  View Cart  View Your ProHealth Vitamin and Supplement Shopping Cart
800-366-6056  |  Contact Us  |  Help
Facebook Google Plus
Fibromyalgia  Chronic Fatigue Syndrome & M.E.  Lyme Disease  Natural Wellness  Supplement News  Forums  Our Story
Store     Brands   |   A-Z Index   |   Best Sellers   |   New Products   |   Deals & Specials   |   Under $10   |   SmartSavings Club

Trending News

Friendly User's Guide for the Timing of Nutritional Supplements

The Health Benefits of Manuka Honey

Increase Your Magnesium Intake

Vitamin D supplementation could ease IBS symptoms

Top Tips to Boost Your Immunity

11 Amazing Health Benefits of Using Baking Soda

Nicotinamide riboside shows promise for treatment of Alzheimer’s disease

Exercise, calcium, vitamin D, and other factors linked with fewer injurious falls

Vitamin D3 Is a Powerhouse for Your Heart

Curcumin Supplementation May Impart Long-Term Cognitive Benefits

Print Page
Email Article

The Lyrica Effect: Lyrica Study Uncovers Key Brain Abnormalities in Fibromyalgia

  [ 37 votes ]   [ 2 Comments ]
By Cort Johnson • • November 6, 2013

The Lyrica Effect: Lyrica Study Uncovers Key Brain Abnormalities in Fibromyalgia

Reprinted with the kind permission of Cort Johnson and Health Rising.

A Blockbuster Drug

Lyrica truly merits the description ‘blockbuster drug’. FDA approved for seizures, neuropathic pain, fibromyalgia (2007), and generalized anxiety disorder (Europe), Lyrica (pregabalin) sales hit their peak in the last quarter in the US, bringing in over $550 million for Pfizer.

Lyrica’s success – despite issues with side effects and efficacy in a significant number of fibromyalgia patients – highlights the tremendous need for drugs that relieve neuropathic pain. Fifteen years in development, Lyrica was originally developed to reduce seizures by increasing GABA levels, but was later found to reduce glutamate, substance P and norepinephrine levels instead.

Researchers know the pharmacological effects Lyrica [pregabalin] has, but they don’t know what parts of the brain it’s affecting. It’s great to have a drug that works (for some people) but finding out why and where a drug works can help us understand what went wrong in the first place. This type of reverse engineering is happening in ME/CFS with Drs. Fluge and Mella (rituximab), and Dr. Montoya and Dr. Kogelnik (antivirals).

In this study, as FM and healthy controls got their thumbnails pressed to induce pain, fMRIs were used to determine which parts of their brains became activated before and after they took Lyrica. Reduced brain activation in concert with reduced pain should reveal which parts of a fibromyalgia patient’s brain were producing pain.


With their exquisite sense of pain, it perhaps wasn’t surprising to see almost 50% more brain regions light up in the presence of pain in the FM patients than in the healthy controls pre-Lyrica. Post-Lyrica things changed, at least for some.

The study showed that when Lyrica works, it really works. It was only effective in less than half those who tried it (9/21) but it cut the responders’ pain in half, dropped their ‘pain sensitivity’ down to normal levels, and their sleep and fatigue scores improved significantly.

Post-Lyrica the responders’ brains were very different as well. Now, the same number of brain regions as in healthy controls became activated during pain. It was as if a sort of “pain infection” that had infected neighboring brain regions had been stopped and reversed. Reductions in insula, somatosensory cortex, and thalamus activity suggested these regions, in particular, play an important role in pain in FM.

Focus on Mind/Body Integration in the Insula

One of the most interesting organs in the brain, the insula plays an important role in both physiology and emotion. One of the chief homeostatic organs in the brain, the insula is in charge of adjusting the body’s physiology (heart rate, temperature, blood sugar, etc., to maintain an even, healthy state. It helps determine how much pain you experience. It lights up in the presence of fear. It’s associated with awareness and cognitive issues. It’s involved in determining ‘anticipation’ (i.e., if just the thought of doing something makes you feel ill, that could be your over-active insula talking).

Lyrica’s ability to reduce activity in two areas of the insula and the cingulate cortex suggested that the ‘motivational affective component of pain’ (i.e., the part of pain that is so unpleasant that it makes you want to crawl out of your skin), is increased in FM.

Arousal and Sensory Integration in the Deep Brain: Focus on the Thalamus

The reduced level of thalamus and somatosensory cortex activity post-Lyrica suggested that the aberrant pain signaling process in FM may begin deep in the brain. The thalamus, which sits right on top of the brainstem, relays sensory and motor signals from the spinal cord to the rest of the brain and regulates sleep and alertness. Long thought as a ‘switchboard,’ it’s now clear that the thalamus processes and determines the flow of information to the rest of the brain.

An overactive thalamus could conceivably reflect breakdowns earlier in the sensory routing system (the Lights’ and Van Elzekker’s suggestion of over-active sensory neurons) that caused massive amounts of sensory information to smack the thalamus.

The thalamus’s regulation of arousal and alertness also suggests it could contribute to the wired and tired issues in ME/CFS/FM. Lyrica’s ability to reduce pain and fatigue and improve sleep and reduce fatigue suggests pain and arousal may be two sides of the same coin in FM, something that certainly makes subjective sense.

This study and others suggest insula, thalamus, and somatosensory cortex over-activation is wreaking havoc with the pain levels, arousal, and possibly emotions in fibromyalgia, and perhaps in ME/CFS.

(A successful Lyrica chronic fatigue syndrome study currently under way could tell us more about Lyrica’s mode of action and the genetics of pain production in ME/CFS. By charting gene expression levels in ME/CFS patients pre- and post-Lyrica, the Lights are hoping they can identify specific genes that are responsible for pain, arousal, sleep problems and other issues in ME/CFS.)

Sidebar – Why Cognitive Behavioral Therapy (CBT) May Not Work Well in Fibromyalgia/ME/CFS

A fascinating study used insula activity to determine whether people with depression do better with an antidepressant (Lexapro) or ‘talk therapy’ (Cognitive Behavioral Therapy). It turned out that while people with low insula activity responded well to CBT, those with high insula activity responded better to Lexapro. Given the increased insula activity generally found in FM/ME/CFS, this suggests that antidepressants or other agents might work better than CBT.

Turning Down Insula and Thalamic/Somatosensory Activity in FM and ME/CFS

If insula, thalamus, and somatosensory cortex activity is increasing your pain, upping your stress levels with negative anticipation, dysregulating your autonomic nervous system and physiology, and overall just giving you a bad time, what can you do about it?

Some treatments that can reduce insula, thalamus and somatosensory cortex are below:

  • Meditation – has been found to reduce somatosensory cortex activity and pain.

  • Lyrica – reduces insula and somatosensory cortex activity in some people with FM.

  • Tropisetron – Tropisetron, a serotonin 5-HT 3 receptor antagonist, reduced pain and blood flow in the somatosensory cortex, the insula, and the anterior cingulate cortex in fibromyalgia.

  • Deep brain stimulation and trans-cranial magnetic stimulation appears to be able to reduce activity in these areas.

  • Antidepressants – While the study noted earlier used Lexapro, a similar effect might be found with similar antidepressants.

  • ???


About the Author:  Cort Johnson has had ME/CFS for over 30 years. The founder of Phoenix Rising and Health Rising, Cort has contributed hundreds of blogs on chronic fatigue syndrome, fibromyalgia and their allied disorders over the past 10 years. Find more of Cort's and other bloggers' work at Health Rising

First image courtesy of dream designs /

Post a Comment

Featured Products From the ProHealth Store
Ultra EPA  - Fish Oil Optimized Curcumin Longvida® Ultra ATP+, Double Strength

Article Comments Post a Comment

Posted by: pearls
Nov 20, 2013
I was diagnosed with fibromyalgia in 2001, and was put on a wide variety of drugs over time, and took as many as ten at a time. Each time, my doctor would as if the drug was helpful, and my response for most was, "I don't know. Maybe it would have been worse without it."

However, about a year after Lyrica was approved for the use of fibromyaliga, I tried it. Wow! Now I really knew how to answer the question. The difference was like night and day. Almost immediately, my pain levels decreased dramatically and my sleep was also improved in a big way.

Being on Lyrica allowed me to wean off everything except Lyrica, and I've recently decreased even the Lyrica from 300MG daily to 200 MG per day. There is not question to me that Lyrica is doing something to the part of the brain that has been seriously impaired.
Reply Reply

Author's qualifications
Posted by: Webmind
Jan 7, 2014
I'm wondering if the author of this article and many others is a physician or has any formal scientific training?
Reply Reply
Optimized Curcumin Longvida with Omega-3

Featured Products

Ultra ATP+, Double Strength Ultra ATP+, Double Strength
Get Energized with Malic Acid & Magnesium
FibroSleep™ FibroSleep™
The All-in-One Natural Sleep Aid
Mitochondria Ignite™ with NT Factor® Mitochondria Ignite™ with NT Factor®
Reduce Fatigue up to 45%
Ultra EPA  - Fish Oil Ultra EPA - Fish Oil
Ultra concentrated source of essential fish oils
Energy NADH™ 12.5mg Energy NADH™ 12.5mg
Improve Energy & Cognitive Function

Natural Remedies

Block food Cravings At Their Molecular Root Block food Cravings At Their Molecular Root
Red Yeast Rice - Natural Option for Supporting Healthy Cholesterol Red Yeast Rice - Natural Option for Supporting Healthy Cholesterol
Fatigue & Fibro Fog: Could You Have a B-12 Deficiency? Fatigue & Fibro Fog: Could You Have a B-12 Deficiency?
Block Acid Reflux to Prevent Esophageal Problems! Block Acid Reflux to Prevent Esophageal Problems!
Herbal Rescue for High Blood Sugar Herbal Rescue for High Blood Sugar

ProHealth, Inc.
555 Maple Ave
Carpinteria, CA 93013
(800) 366-6056  |  Email

· Become a Wholesaler
· Vendor Inquiries
· Affiliate Program
Credit Card Processing
Get the latest news about Fibromyalgia, M.E/Chronic Fatigue Syndrome, Lyme Disease and Natural Wellness

CONNECT WITH US ProHealth on Facebook  ProHealth on Twitter  ProHealth on Pinterest  ProHealth on Google Plus

© 2018 ProHealth, Inc. All rights reserved. Pain Tracker App  |  Store  |  Customer Service  |  Guarantee  |  Privacy  |  Contact Us  |  Library  |  RSS  |  Site Map