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Re: Will Benzo tolerance = Lyrica tolerance » schleprock

Posted by SLS on August 14, 2012, at 21:55:36

In reply to Will Benzo tolerance = Lyrica tolerance, posted by schleprock on August 14, 2012, at 15:13:44

> Forgot to ask my pdoc this, but it feels like I might be developing a tolerance to clonazepam (gradually increased to the current 1.5 mg over the last few months, and not my first time on the drug.) When prescribing today (for anxiety\depression), my pdoc mentioned, in a very general way, that Lyrica does alot of what clonazepam does. If I'm already somewhat tolerant to the benzo, will I be tolerant to Lyrica as well? Does Lyrica "tolerance" even exist? Thanks.

I doubt that there is cross-tolerance between these two drugs. In other words, you won't be tolerant of Lyrica as the direct effect of previous exposures to benzodiazepines. However, that doesn't mean that Lyrica won't poop-out. Hopefully, you will receive some personal anecdotes as responses to your questions. For me, Lyrica produced a mild antidepressant effect that lasted for less than a week. Thereafter, it did more harm than good.

BZD = benzodiazepine
GABA = gamma aminobutyric acid
NE = norepinephrine
DA = dopamine

The mechanisms of action underlying the anxiolytic effects of Lyrica and clonazepam are different. Clonazepam attaches to the BZD binding site of the GABA receptor, thereby enhancing its stimulation. Lyrica binds to the alpha2delta-1 subunit of the voltage gated calcium channel, thus reducing vesicular glutamate release. Both of these diverse mechanisms result in the inhibition of glutamate activity. Glutamate hyperactivity contributes to the expression of anxiety. In addition, NE release, but not DA release is reduced by Lyrica via a reduction in K+ currents. This should reduce anxiety (amygdala) without producing depression (nucleus accumbens).

Nardil?
Effexor?
Paxil?


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