Pregabalin (Lyrica®) is an antiepileptic drug that reduces the excitability of the nerve cells but also has an analgesic, anxiolytic and sedative effect. It is used in epilepsy therapy for partial onset seizures, various nerve pain, generalized anxiety disorder, and social phobia. In the US, it is also approved for the treatment of fibromyalgia. How accurate pregabalin works, what dosage is appropriate and what side effects can occur, read in this article.
What is pregabalin?
Pregabalin is an active ingredient in the group of antiepileptics, also called anticonvulsants, and is sold, inter alia, under the trade name Lyrica® in Germany. Meanwhile, however, many generics are on the market.
Antiepileptic drugs reduce the excitability of nerve cells and are used to treat epilepsy.
Treat with pregabalin epilepsy
Pregabalin plays a role in the long-term therapy of so-called stroke attacks with or without secondary generalization, special forms of epilepsy. It is always given as an adjunct drug in combination with other epilepsy drugs, for example with lamotrigine. Pregabalin has been shown to reduce seizure frequency or even to achieve seizure freedom.
Pregabalin vs. gabapentin
Pregabalin is the successor of gabapentin, an established epilepsy drug. Its advantage compared to other antiepileptic drugs is that it causes fewer side effects, is easier to metabolize in the body and better targets at its target site.
In addition, unlike gabapentin, it is approved for the treatment of other conditions, such as nerve pain and anxiety disorders.
Even with pain and anxiety
Another major application is nerve pain. Nerve pain is characterized by tingling and burning and caused by certain messenger substances whose release Pregabalin inhibits. Therefore, it is an alternative for other antiepileptic drugs such as carbamazepine and gabapentin. It helps for example in pain of herpes zoster disease or the syndrome of postherpetic neuralgia, diabetic neuropathy and spinal cord injuries.
Furthermore, it is used in the treatment of generalized anxiety disorder and social phobia. Other possible drugs in the treatment of generalized anxiety disorder include duloxetine and venlafaxine.
In the US, pregabalin is also approved in the treatment of fibromyalgia. It has been proven to have a pain-relieving effect and is already used in Germany in patients with fibromyalgia, but has not yet received official approval. Alternatively, one can resort to old proven drugs such as amitriptyline for the treatment of fibromyalgia.
Pregabalin dose and settle
Pregabalin is offered in the form of capsules or as a solution. It can be taken independently of the meals. It is important that pregabalin must be phased in gradually over a period of at least two weeks.
The normal starting dose of 150 mg a day is divided into two to three single doses, with a maximum dose of 600 mg a day. Which dosage actually comes into question for you, must determine the attending physician.
How fast does pregabalin work? After a week, the first effects usually appear.
In the case of termination of therapy, pregabalin must also be gradually withdrawn, as otherwise severe side effects may occur. A sudden withdrawal of pregabalin may cause the symptoms to recur worse than before.
Side effects of pregabalin
The most common adverse reactions of pregabalin are:
- a headache
Also the attention can be disturbed. Therefore, no car should be driven while taking Pregabalin and the use of complex machinery is prohibited.
In addition, blurred vision, double vision and erectile dysfunction can be side effects. Some patients taking pregabalin also report weight gain.
There is also evidence that pregabalin may be addictive, especially if there is already a history dependency.
Interactions with pregabalin
Since pregabalin is hardly metabolized in the body and excreted almost unchanged via the kidneys, it has little interaction with other drugs.
However, caution should be exercised with concomitant use with depressants such as alcohol, benzodiazepines or opioids. In this combination it can come to respiratory arrest up to a coma.
Contraindications of the active substance
The main contraindications of pregabalin are:
- Hypersensitivity to the drug
- pregnancy and breast feeding period
- Use in children
- severely impaired kidney function
How does pregabalin work?
Pregabalin has a similar chemical structure as the nerve cell messenger GABA, an inhibitory hormone. It attaches to the same calcium channels of nerve cells in the brain and body, thereby reducing the release of activating messengers such as glutamate, norepinephrine and substance P.
The effect is that the nerve cells can be less aroused, which relieves pain and relieves anxiety and reduces the risk of epileptic seizures.