Medication induced weight gain is a well-known phenomenon in bariatrics and occurs with some of the most commonly prescribed medications, such as insulin, antihistamines, and steroids.
Does Lyrica cause weight gain?
Yes. It certainly can but as with everything in the medical field it depends on the individual and several other variables. Lyrica and its popular predecessor Gabapentin (Neurontin) have both been shown to cause significant weight gain. In a 2008 study, patients taking Lyrica for epilepsy, gained approximately 4 kg (8 lb) in a 3 to 6-month period. The amount of weight gained increased with escalating doses of Lyrica, with the largest amounts of weight gained with the 600 mg daily dose.
Are there alternatives for patients gaining weight with Lyrica?
It is important before stopping any medications that you first discuss your concerns with your doctor. There are side effects to not only taking medications but also stopping them abruptly. Next, it is important to understand that some medications are lifesaving and the risk of side effects such as gaining weight may outweigh the risk of a major medical event. In the case of Lyrica, it is indicated for several conditions such as epilepsy, neuropathic pain, and fibromyalgia, therefore, the burden of treatment depends on the reason for taking the medication. In the case of seizure treatment, for example, this decision will heavily depend on the best medication for managing seizure activity.
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Alternatives for Seizure Disorder
Lyrica is indicated as an adjunct to seizure therapy for partial onset seizures (also known as simple seizures). For individuals looking to lose weight, topiramate (or Topamax) is a reasonable alternative. This anti-epileptic medication has been shown to induce weight loss and reduce binge eating. In a study published in the Obesity Reviews Journal, individuals taking Topirmate for 16 weeks lost approximately 5 kg (10 lbs). In addition, individuals taking topiramate continued losing weight for the duration of the trial. Due to the promise of effective weight loss the extended release version of topiramate was added in combination with phentermine in the FDA approved weight loss medicine Qsymia. Other alternative anti-epileptics that do not cause weight gain include Lamotrigine, Phenytoin, and Zonisamide. These medications are “weight neutral”, meaning they neither cause weight gain or weight loss.
Lyrica in Diabetes
Lyrica is often used in diabetes for peripheral neuropathy or nerve pain. Patients with diabetes have a propensity to gain weight due to changes in metabolism, the nature of the disease, and the physiological response to carbohydrates and exogenous insulin. Therefore, adding yet another weight gaining medication should be avoided when possible. For diabetic neuropathy, diabetes and blood glucose control are the most essential strategies for reducing neuropathy. The first step to managing blood glucose is eating a diet low in simple, refined, and processed carbohydrates and remaining compliant with anti-diabetic medications (at least until they can be titrated down or off). For diabetes, adequate physical activity aids in glucose control as well by increasing basal metabolic rate, moving glucose into healthy lean muscle, and lowering insulin resistance. The adult physical activity recommendation for individuals with diabetes is 60 minutes a day, 6 days a week.
Lyrica for pain and other neuropathies
The #1 cause for peripheral neuropathy is diabetes but it can also be caused by malnutrition, alcoholism, shingles, and B12 deficiency. Therefore, the alternative treatments for these conditions is managing the underlying issue. For example, in the case of vitamin B12 deficiency, individuals lacking B12 in the diet should ingest foods high in B12 such as liver, beef, tuna, pork chops, oysters, cottage cheese, yogurt, eggs, ready to eat cereals, and milk. For those unable to eat foods high in B12, such as vegans or vegetarians, they should opt for vitamin supplementation. For individuals with fibromyalgia, exercise and food sensitivity testing have been found to provide hope for long-term solutions.
Have more weight related questions? Read our section: Dr Covington answers your questions for more
DeToledo JC, Toledo C, DeCerce J, et al. Changes in body weight with chronic, high dose gabapentin therapy, Ther Drug Monit 1997; 19:394-6.
Hoppe C, Rademacher M, Hoffman JM et al. Bodyweight gain under pregabalin therapy in epilepsy: Mitigation by counseling patients? Seizure 2008; 17:327-32.
Kramer CK1, Leitão CB, Pinto LC, Canani LH, Azevedo MJ, Gross JL. Efficacy and safety of topiramate on weight loss: a meta-analysis of randomized controlled trials. Obes Rev. 2011 May;12(5):e338-47. doi: 10.1111/j.1467-789X.2010.00846.x. Epub 2011 Mar 28.