Lyrica (Pregabalin) is a drug that is approved for the treatment of neuropathic pain as well as partial seizures in adults. In some countries (outside the United States) it has also been successfully used for the treatment of anxiety disorders. Lyrica is often preferred over opioid medications in the treatment of chronic pain as well as fibromyalgia due to its low potential for abuse and addiction.
It is considered the successor to the drug Gabapentin, but whether it is a superior medication is highly debatable. Although the drug can be highly effective for some individuals in the treatment of various types of pain, as well as reducing the occurrence of seizures, many people are dissatisfied with the drug’s side effect profile. One of the most distressing side effects that people experience is that of weight gain.
Lyrica and Weight Gain
It is estimated that approximately 1/10 people taking Lyrica will experience significant weight gain throughout their treatment. Others taking the medication may experience an increase in their weight and/or BMI (body mass index), but the increase may not be of clinical significance. A majority of Lyrica users do not report noticeable changes in weight throughout their treatment, which is why many doctors consider it “weight neutral” or unlikely to affect weight.
How Lyrica Causes Weight Gain
There are many theories in regards to how Lyrica may cause weight gain. Some believe that the majority of weight gained is a result of the drug causing increased water retention, while others believe that the drug slows metabolism and can beef up a person’s appetite.
- Appetite increase: Although most people don’t report a major increase in appetite, some do. If you’ve found yourself shoveling down more food while on the drug than you had pre-drug, there’s a good chance it may be boosting your appetite. An increase in appetite generally leads to increased food consumption, which usually causes weight gain.
- Fatigue: If you feel fatigued when taking this medication, it may be difficult to hit the gym for a workout. Some people end up feeling so lethargic as a result of this medication that they find it difficult to get out of bed. The lack of exercise and movement as a result of fatigue inherently slows metabolism and leads to less calories burned – causing weight gain.
- Food cravings: Do you crave certain foods that you didn’t before you started taking the medication? If you begin experiencing cravings for carbohydrates, refined sugars, and other junk foods – it could be a result of neurotransmitter changes from the medication. Changes in certain neurotransmitters can lead to food cravings.
- Hormone levels: There’s a possibility that this drug is influencing levels of various hormones throughout the body. By altering levels of hormones, the drug could cause you to gain weight. Certain hormones such as: leptin, cortisol, and ghrelin may lead to weight gain when altered. Further research needs to be conducted to better understand how Lyrica could induce weight gain via hormone changes.
- Motivational deficit: Since this drug decreases activity in the central nervous system, and tends to cause sedation and fatigue, it may cause your motivation to plummet. This may mean that you have a difficult time getting sufficient exercise. It also may mean that you’ll be less likely to put forth the necessary effort to prepare healthy meals. When motivation levels drop as a result of a medication, this often indirectly leads to weight gain.
- Slower metabolism: This drug is classified as a CNS depressant, meaning it slows activity within the central nervous system. This is partially how it works to help with various types of nerve pain. Since activity in your CNS will be depressed, chances are your metabolism may also slow under the drug’s influence. If you noticed that your exercise and diet was the same pre-drug as during treatment, but you’ve gained weight – it could be a result of a slowed metabolism.
- Social eating: If you find that this drug works well to reduce anxiety and/or depression, you may start to socialize more often. Socializing more frequently may lead to regular dinner plans with friends and/or workmates. Dining out frequently can lead to you eating bigger portions and unhealthier foods than you did in the past – which will ultimately cause weight gain.
- Taste improvement: For those that notice an improvement in mood and functioning after taking Lyrica, an improvement in taste may follow suit. If you notice that food tastes better, it could be due to the fact that the drug helped clear up your depression. It also could be a result of neurochemical changes elicited by the drug.
- Water retention: Some people have hypothesized that a lot of the weight gained on this drug may be a result of increased water retention. If your body is holding more water weight, you’re going to feel bloated, fatter, and will be heavier. Although it may be tempting to use a diuretic to deal with the increase in water retention, this is not recommended as the effects of diuretics can be fatal.
Note: It is important to understand that the specific causes of weight gain may be different based on the individual. One person may notice that they feel more bloated and gain weight as a result of increased water retention, yet another may simply experience an increase in appetite. A third person may have a totally different combined influence of various factors leading to weight gain.
Factors Responsible for Weight Gain on Lyrica
You should also be aware that many other individualized factors play a role in determining how much weight you’ll gain on Lyrica. These tend to include: the dosage you’re taking, how long you’ve been medicated, whether you take other drugs, your lifestyle, as well as your genetics.
If you experience weight gain on this medication, it could be a result of your current dosage. Assuming you are taking a moderate or high dose, it means that more of the drug is circulating throughout your body. The greater the strength of the drug, the more likely it is that you’ll experience unwanted side effects.
For this reason, if you want to minimize the amount of weight gained, it is recommended to always take the minimal effective dose. If you are on a low dose, there will be less of the Lyrica cycling throughout your body and affecting your physiological functions. Always keep in mind that when you double the dose of this drug, you are also potentially doubling the unwanted side effects (e.g. weight gain).
2. Duration of treatment
There is a large body of research suggesting that there are different timelines over which people gain weight on Lyrica. Some people gain weight within the first couple months of treatment, others gain weight after a moderate treatment-term, while others are considered “delayed” weight gainers in that there is no immediate change, but they eventually pack on the pounds. This demonstrates that weight gain patterns are different based on the individual.
Most people (~82%) that gain weight on Lyrica tend to notice after about a year of treatment. Only roughly 7% of individuals taking this drug will notice “delayed” onset of weight gain throughout their treatment. A smaller percentage of users (~3%) notice weight gain in the early stages of their treatment. Therefore if you do gain weight, it’s likely going to take time and still may not be considered extreme.
3. Other medications
Another important thing to keep in mind is whether you are on any other medications, supplements, or use drugs. If you are on a stack of medications and supplements, it is important to consider how these may be affecting your weight. Many people like to place blame on Lyrica, when in fact another drug like an SSRI and/or an antipsychotic may be responsible for their major weight gain.
If you take other drugs, talk to your doctor about potential interaction effects and try to figure out which of the medications is most likely the culprit for your weight changes. Also realize that if you are taking stimulatory medications (e.g. Adderall), these may counterbalance some of the weight gain that you may have experienced on Lyrica.
While Lyrica may certainly be culpable for the weight that you’ve packed on, it is not the only influential factor. Your daily regimen including the amount of exercise you get, sleep quality (and quantity), stress level, and dietary intake can all directly affect whether you gain weight. Someone who is eating a poor diet and isn’t taking care of themselves may gain weight on Lyrica, but they won’t be able to really know whether it was the drug or it was their unhealthy lifestyle. Before you blame a drug for all of your weight gain, make a conscious effort to be healthy so that you truly know whether the Lyrica is responsible for your extra baggage.
While we do not have the full technology to determine exactly how Lyrica is interacting with your genetics, some speculate that certain genetic variations may be responsible for weight gain on medications. Genetic variations may explain why some people end up gaining weight while taking Lyrica and other people remain “weight neutral.” Fortunately new technologies have emerged like GeneSight to help us get a better understanding of whether we are likely to benefit from Lyrica and experience side effects like weight gain.
- Source: http://www.ncbi.nlm.nih.gov/pubmed/24308788
How much weight will you gain on Lyrica?
There’s no telling exactly how much weight you’ll gain from this medication because it is largely based upon individual circumstances. Assuming you are one of the people that end up gaining weight on this medication, it is likely that you’ll gain between 5 lbs. and 15 lbs. within your first year of treatment. Most studies that show people who gain weight over the course of 1-year’s treatment end up gaining between 12 lbs. and 14 lbs.
- Source: http://www.ncbi.nlm.nih.gov/pubmed/22494020
Does everyone gain weight from Lyrica?
Some studies have suggested that only 10% of individuals will experience weight gain on Lyrica, while others have suggested that over 20% of people gain weight. From the perspective of a pharmaceutical company, promoting a medication as having less weight gain is advantageous in that more people are likely to try it. If a doctor tells you that the drug isn’t likely to affect weight, you probably would rather try it than a medication that is linked to weight gain.
It could be that the results are somewhat selectively skewed to promote the image that Lyrica is weight neutral when it causes weight gain. However, there is still a lot of data from independent research suggesting that significant weight gain is unlikely in the bulk of patients. Certainly not everyone will experience noticeable weight gain on this medication, but between 10% and 24% of people do.
Comparing Lyrica’s therapeutic benefit vs. weight gain
If you are taking Lyrica, it is important to evaluate how well the drug is working to treat the condition for which you take it. Next evaluate whether the therapeutic benefit outweighs the side effects that you’ve experienced such as weight gain, dizziness, and low energy. If the drug is working well to treat symptoms of nerve pain or seizures, you probably won’t mind a little bit of weight gain.
However, if the drug isn’t working as well as you’d hoped, and you have experienced more than just a “little” weight gain, you may want to talk to your doctor about other options and/or Lyrica withdrawal. It is important not to get too caught up in the side effects if you really need this drug to function, but when the side effects such as weight gain become so severe that they affect your daily functioning, it’s time to reconsider the treatment.
Did you gain weight from Lyrica?
If you’ve taken Lyrica (or are currently taking it), be sure to share whether you experienced weight gain or remained relatively weight neutral. If you ended up gaining weight, feel free to mention how much you gained, why you think you gained it, as well as any strategies you found helpful for reducing it. To help others get a better understanding of your situation, you may want to include information about your dosage, how long you had been taking it, whether you took other medications, and other possible factors that may have influenced your weight.
- Source: http://www.ncbi.nlm.nih.gov/pubmed/25149863
- Source: http://www.ncbi.nlm.nih.gov/pubmed/23808960
- Source: http://www.ncbi.nlm.nih.gov/pubmed/24843530