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Pregabalin vs Gabapentin, Adverse Effects, Risks & Treatment

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Gabapentin and Pregabalin were significantly effective. Gabapentin, however, reduced pain more effectively than Pregabalin and was linked to fewer, less severe adverse events (AEs). Gabapentin should be started earlier than Pregabalin to allow for the best crossover.

Gabapentin Vs Pregabalin Side Effects

Pregabalin and gabapentin are used as anti-epileptic medications to treat nerve pain. Both pregabalin and gabapentin have been associated with withdrawal syndromes on discontinuation. Some side effects, such as dizziness, drowsiness, loss of balance or coordination, problems with memory or concentration, tremors, and vision problems (blurred vision or double vision), have been reported with both drugs. If you believe you or someone you love may be struggling with pregabalin vs gabapentin withdrawal, let us hear your story and help you determine a path to treatment.

What is Pregabalin(Lyrica)?

Pregabalin capsules, oral solution (liquid), and extended-release (long-acting) tablets are used to treat diabetic and postherpetic neuralgia neuropathic pain (pain from damaged nerves) in your arms, hands, fingers, legs, feet, or toes (PHN; the burning, stabbing pain or aches that may last for months or years after an attack of shingles). Pregabalin capsules and oral solution are also used to treat fibromyalgia and relieve neuropathic pain after a spinal cord injury (a long-lasting condition that may cause pain, muscle stiffness and tenderness, tiredness, and difficulty falling asleep or staying asleep).

Pregabalin capsules and oral solution are used with other medications to treat certain types of seizures in adults and children aged one month and up. Pregabalin belongs to the anticonvulsant medication class. It works by reducing the number of pain signals sent out by the body’s damaged nerves.

How Should Pregabalin Be Used?

Pregabalin is available as a capsule, an oral solution, and an extended-release tablet to be taken orally. Pregabalin capsules and oral solution are typically taken twice daily, with or without food. Pregabalin extended-release tablets are typically taken once daily after dinner. Therefore, pregabalin should be taken at the same time(s) every day. Follow the instructions on your prescription label strictly, and ask your doctor or pharmacist to explain any parts you don’t understand.

Do not cut, chew, or crush the extended-release tablets; instead, swallow them whole. During the first week of treatment, your doctor will likely start you on a low dose of pregabalin and gradually increase it. Pregabalin should be taken exactly as prescribed. Pregabalin has the potential to become addictive. Please do not take a higher dose, take it more frequently, or take it for a more extended period than your doctor has prescribed.

Pregabalin is available as a capsule, an oral solution, and an extended-release tablet to be taken orally. Pregabalin capsules and oral solution are typically taken twice daily, with or without food. Pregabalin extended-release tablets are typically taken once daily after dinner. Therefore, pregabalin should be taken at the same time(s) every day. Follow the instructions on your prescription label strictly, and ask your doctor or pharmacist to explain any parts you don’t understand.

Pregabalin Effects

Pregabalin may have unwanted side effects. Inform your doctor if any of the following symptoms are severe or persistent:

  • tiredness
  • dizziness
  • headache
  • dry mouth
  • nausea
  • vomiting
  • difficulty remembering or forgetfulness
  • weight gain
  • constipation
  • gas
  • bloating
  • ”high” or elevated mood
  • speech problems
  • difficulty concentrating or paying attention
  • increased appetite
  • back pain
  • anxiety
  • lack of coordination
  • loss of balance or unsteadiness
  • uncontrollable shaking or jerking of a part of the body
  • muscle twitching
  • weakness

Pregabalin Long-Time Effects

In the long-term treatment of anxiety disorders, pregabalin was generally well tolerated. In addition, the severity of the illness improved over time. The study’s main limitations were that it was not randomized and was neither placebo- nor active-comparator-controlled.

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What is Gabapentin?

Gabapentin is in a class of medications called anticonvulsants. Gabapentin treats seizures by decreasing abnormal excitement in the brain. Gabapentin relieves PHN’s pain by changing how the body senses pain. It is not known exactly how gabapentin works to treat restless legs syndrome.

Gabapentin capsules, tablets, and oral solutions are used with other medications to help people with epilepsy control certain types of seizures. Gabapentin capsules, tablets, and oral solution are also used to treat postherpetic neuralgia pain (PHN; the burning, stabbing pain or aches that may last for months or years after an attack of shingles). In addition, restless legs syndrome is treated with gabapentin extended-release tablets (Horizant) (RLS; a condition that causes discomfort in the legs and a strong urge to move the legs, especially at night and when sitting or lying down).

Gabapentin Effects

  • tiredness
  • dizziness
  • headache
  • dry mouth
  • nausea
  • vomiting
  • difficulty remembering or forgetfulness
  • weight gain
  • constipation
  • gas
  • bloating
  • ”high” or elevated mood
  • speech problems
  • difficulty concentrating or paying attention
  • increased appetite
  • back pain
  • anxiety
  • lack of coordination
  • loss of balance or unsteadiness
  • uncontrollable shaking or jerking of a part of the body
  • muscle twitching
  • weakness

Gabapentin Long-Time Effects

Long-term gabapentin use has been linked to several health problems that can persist long after the drug has been discontinued. The following are some of the most common long-term side effects of gabapentin use:

  • Mood swings
  • Behavioral modifications
  • Depression
  • Anxiety
  • Memory lapses
  • Muscle weakness

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It is reported in the study to see the effects of Gabapentin vs Pregabalin on pain intensity in adults with chronic sciatica that 12 of 18 patients who participated in the study had the adverse impact of weight gain from taking Pregabalin. In contrast, no effects have been shown from Gabapentin.

Side Effects of Pregabalin vs Gabapentin

Because Pregabalin vs gabapentin are both gabapentinoids, they share many side effects. For example, both medicines have been linked to dizziness, drowsiness, loss of balance or coordination, memory or concentration problems, tremors, and vision problems (blurred vision or double vision). In addition, both Lyrica and gabapentin have been linked to withdrawal symptoms when stopped.

Pregabalin vs Gabapentin Weight Gain

It is reported in the study to see the effects of Gabapentin vs Pregabalin on pain intensity in adults with chronic sciatica that 12 of 18 patients who participated in the study had the adverse impact of weight gain from taking Pregabalin. In contrast, no effects have been shown from Gabapentin.

Pregabalin vs Gabapentin for Nerve Pain

While Pregabalin vs Gabapentin were significantly effective in lowering pain intensity in patients with Chronic Sciatica, Gabapentin was superior when compared head to head, according to this randomized controlled trial’s planned interim analysis. Moreover, regardless of the sequence order, Gabapentin was linked to fewer and less severe AEs.

Pregabalin vs Gabapentin were considerably effective at reducing pain-related impairment (as measured by ODI), but none stood out when put head-to-head.

Both Pregabalin vs Gabapentin were significantly effective. Gabapentin, however, reduced pain more effectively than Pregabalin and was linked to fewer, less severe adverse events (AEs). For ideal crossover, Gabapentin should be started before

FAQs

How Does Pregabalin vs Gabapentin Work?

Pregabalin and gabapentin are used as anti-epileptic medications to treat nerve pain. 

Is Pregabalin and Gabapentin Addictive?

Pregabalin and gabapentin have been associated with misuse, and in some countries, they are classified as controlled substances. 

What will happen if you suddenly stop taking Pregabalin vs Gabapentin?

Both Lyrica and gabapentin have been associated with withdrawal syndromes on discontinuation.

Pregabalin vs Gabapentin for Neuropathic Pain

The study’s goal was to look at the safety and efficacy of Pregabalin vs Gabapentinn in treating SCI-related neuropathic pain. This is the first systematic review and meta-analysis in which the two drugs have been directly compared. A systematic review of head-to-head trials provides the best evidence for comparing the efficacy of the two interventions.

According to the findings of our meta-analysis, there is no discernible difference between Pregabalin vs Gabapentin in terms of their effectiveness in relieving pain. Similar to the current investigation results, earlier systematic reviews indicated that both medications helped alleviate neuropathic pain caused by SCI. But Pregabalin and Gabapentin were not compared in the research that was part of these evaluations.

Numerous systematic reviews found no discernible difference between Pregabalin vs Gabapentin’s efficacy in treating people with SCI, which is statistically comparable to our study’s findings. Contrarily, evidence demonstrates that outcomes of indirect comparisons typically agree with those of direct comparisons. The current study’s conclusions diverge from several earlier review studies that contrasted Pregabalin and Gabapentin with a placebo. According to those research findings, Pregabalin is superior to Gabapentin in treating neuropathic pain brought on by SCI. The absence of head-to-head comparisons in those research can be blamed for these discrepancies.

This meta-analysis revealed that Pregabalin was more successful than a placebo in treating neuropathic pain, sleep disturbances, anxiety, and depression. In contrast, Gabapentin was more effective than a placebo in treating various types of pain.

Pregabalin vs Gabapentin Fact Sheet

Pregabalin

Pregabalin, sold under the brand name Lyrica among others, is an anticonvulsant, analgesic, and anxiolytic medication used to treat epilepsy, neuropathic pain, fibromyalgia, restless leg syndrome, opioid withdrawal, and generalized anxiety disorder. 

Gabapentin

Gabapentin, sold under the brand name Neurontin, is an anticonvulsant medication primarily used to treat partial seizures and neuropathic pain. 

Both pregabalin and gabapentin are used as anti-epileptic medications to treat nerve pain. But there are several differences between them. The main differences between Lyrica and gabapentin are the following:

Side Effects

  • Pregabalin is more likely than gabapentin to cause side effects such as dry mouth, constipation, swelling (edema), breast enlargement, or weight gain
  • Gabapentin is more likely than pregabalin to cause side effects such as difficulty speaking, fever, an increased risk of viral infections, unusual eye movements, or jerky movements
  • There is some evidence that pregabalin may have a higher addiction potential than gabapentin due to its faster absorption and onset of action
  • Both pregabalin and gabapentin have been associated with withdrawal syndromes on discontinuation.

Controlled Substance

Both pregabalin and gabapentin have been associated with misuse and in some countries, they are classified as controlled substances. Pregabalin is classified as a schedule 5 controlled substance in the United States. Gabapentin is not classified as a controlled substance at a Federal level, however, some states in the U.S. have classified gabapentin as a controlled substance at a state level. The states that have classified gabapentin as a controlled substance are Kentucky, Virginia, West Virginia, Michigan, and Tennessee. States that include gabapentin in their prescription drug monitoring programs include Minnesota, Ohio, Illinois, Massachusetts, and Wyoming.

Pregabalin vs Gabapentin for Anxiety

According to the available data, pregabalin is safe and effective in treating GAD, whether used alone or in conjunction with first-line pharmacotherapy (such as selective serotonin reuptake inhibitor/serotonin-norepinephrine reuptake inhibitor antidepressants). For patients with refractory GAD and a coexisting chronic pain condition, pregabalin may be an appropriate treatment option. Pregabalin abuse and dependence have been documented. However, most at-risk individuals had a history of abusing opiates or other drugs. The abuse risk appears comparable to other well-known second-line therapies for GAD but needs to be more carefully defined. In addition, pregabalin is now more expensive than alternative medicines like benzodiazepines and second-generation antidepressants for treating anxiety disorders in the United States since it is used off-label.

Pregabalin and gabapentin are pharmacodynamically similar or identical, and gabapentin is more readily available and less expensive in the US. Although the existing data does not entirely support this claim, gabapentin may be a viable substitute for pregabalin in treating anxiety disorders. However, a variation in efficacy between pregabalin and gabapentin’s pharmacokinetics may exist.

It appears doubtful that the industry will invest in the pivotal controlled trials required to obtain regulatory approval for gabapentinoids for anxiety disorders. Hence their usage for this condition will continue to be off-label. However, regulatory scheduling is likely to start influencing prescription decisions. For example, in patients with neuropathic pain and associated illnesses, gabapentinoids are prescribed more frequently as an alternative to opiates. In addition, pregabalin and gabapentin may be rescheduled into greater abuse liability categories when they come under review as potentially abused drugs.

Pregabalin vs Gabapentin for Restless Legs

Pregabalin shares chemical similarities with gabapentin and is used clinically to treat restless legs syndrome, neuropathic pain, and seizures. Compared to gabapentin enacarbil and pregabalin, gabapentin has not been as well explored in the treatment of restless legs syndrome, but the information currently available and clinical experience point to similar outcomes.

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Pregabalin vs Gabapentin Dosage

Pregabalin Dosage

Pregabalin and placebo were compared over four to sixteen weeks in fourteen RCTs. The daily doses employed in nine forced titration experiments were 150 mg, 300 mg, 450 mg, or 600 mg. Daily doses beyond 300 mg did not reduce the mean pain score compared to lower doses.

Pregabalin was utilized in five flexible titration trials, with daily doses ranging from 150 to 600 mg in four cases and 300 to 450 mg in the fifth.22–26 The mean final daily dosages of pregabalin were 400–500 mg. At doses of more than 300 mg, one experiment found no benefit in pain alleviation. Unfortunately, the data from the other four studies were not presented in a form that made it possible to compare doses.

Gabapentin Dosage

We examined eight RCTs that compared gabapentin with placebo for four to eight weeks: three trials utilized flexible titration, and five used forced titration. Patients on forced titration were coerced into taking daily doses of 1800 or 2400 mg. The higher amount failed to produce a clinically significant decrease in pain in the one published trial that directly compared 2400 mg/day with 1800 mg/day. In a sizable, unreported study with severe diabetic neuropathy, mean pain scores at dosages of 900, 1200, or 1800 mg/day did not differ from placebo. There was no dose response seen.

Gabapentin doses in flexible titration trials ranged from 400 to 3600 mg daily. Patients in the gabapentin arm of one flexible titration experiment received a median dose of 2400 mg per day, although gabapentin doses over 1200 mg per day did not enhance analgesia.

Pregabalin vs Gabapentin Cost

To examine the cost-effectiveness of pregabalin versus gabapentin in 1000 patients with Peripheral Neuropathic Pain and Postherpetic Neuralgia, we created a 12-week simulation model localized for China. In addition, we used a survey of Chinese key opinion leaders to estimate the pre-treatment distribution of pain scores for Peripheral Neuropathic Pain and Postherpetic Neuralgia. Pregabalin and Gabapentin treatment results were found in the published literature.


Pregabalin is a successful treatment for Postherpetic Neuralgia and Peripheral Neuropathic Pain at an incremental cost of $45 for each additional day of moderate or no pain, with better outcomes including decreased pain scores and a rise in days with no or no discomfort. In addition, pregabalin would give doctors an extra tool to effectively treat patients with Peripheral Neuropathic Pain/Postherpetic Neuralgia, adding a lot of value to the therapy paradigm for Peripheral Neuropathic Pain/Postherpetic Neuralgia.

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Pregabalin vs Gabapentin for Chronic Pain

In crossover investigations, tiredness and drowsiness were the most often reported adverse effects of Pregabalin and Gabapentin. In addition, Pregabalin saw more negative outcomes and treatment-related discontinuations than GBP. Compared to a placebo, our meta-analysis demonstrated that dizziness was a side effect of Pregabalin. However, a study’s findings revealed that Pregabalin was long-term safe and tolerable in patients with central neuropathic pain brought on by SCI. Outcomes of a thorough review. Showed that compared to Gabapentin, Pregabalin had more side effects.

The results of this study imply that Pregabalin and Gabapentin are equally successful in treating the neuropathic pain brought on by SCI. Similarly, comparative studies found no discernible difference between the two medications regarding lowering pain levels. In addition, the two medications’ safety profiles did not significantly differ. Therefore, we advise a network meta-analysis for upcoming research.

Conclusion

Both Gabapentin and Pregabalin were significantly effective. Gabapentin, however, reduced pain more effectively than Pregabalin and was linked to fewer, less severe adverse events (AEs). Gabapentin should be started earlier than Pregabalin to allow for the best crossover.

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The decision to start a journey to recovery can save your life. Look for the best treatment for gabapentin and pregabalin withdrawal.
The decision to start a journey to recovery can save your life. Look for the best treatment for gabapentin and pregabalin withdrawal.

A detox program can be highly beneficial if you seek help for addiction treatment. Look for a professional detox facility that provides a medically assisted withdrawal protocol that will help drug abusers to avoid some of the harsher symptoms of Lyrica withdrawal during detox. 

There are also several medication-assisted treatment (MAT) available that an addiction treatment specialist may prescribe for easing the withdrawal symptoms linked with Lyrica withdrawal and addiction. After completion of detox, it is crucial to participate in a formal addiction treatment program such as behavioral therapy in an inpatient rehab setting. 

Please, do not try to detox on your own at home. The detox process can be painful and difficult without medical assistance. However, getting through the detox process is crucial for continued treatment. We at Level Up NJ provide proper care with round-the-clock medical staff to assist your recovery. So, reclaim your life, call us to speak with one of our treatment specialists. Our counselors know what you are going through and will answer any of your questions. 

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Search Pregabalin vs Gabapentin Detox & Mental Health Topics & Resources
Sources:

[1] National Library of Medicine – Pregabalin

[2] Montgomery S, Emir B, Haswell H, Prieto R. Long-term treatment of anxiety disorders with pregabalin: a 1 year open-label study of safety and tolerability. Curr Med Res Opin. 2013 Oct;29(10):1223-30. doi: 10.1185/03007995.2013.820694. Epub 2013 Aug 19. PMID: 23808960.

[3] National Library of Medicine – Gabapentin

[4] Parke-Davis. (2011). Neurontin (gabapentin).

[5] UpToDate (Oct 2022) Management of restless legs syndrome and periodic limb movement disorder in adults

[6] American College of Clinical Pharamacology (26 March 2018) Gabapentin and Pregabalin for the Treatment of Anxiety Disorders

[7] Davari M, Amani B, Amani B, Khanijahani A, Akbarzadeh A, Shabestan R. Pregabalin and gabapentin in neuropathic pain management after spinal cord injury: a systematic review and meta-analysis. Korean J Pain. 2020 Jan 1;33(1):3-12. doi: 10.3344/kjp.2020.33.1.3. PMID: 31888312; PMCID: PMC6944364.

[8] Robertson K, Marshman LAG, Plummer D, Downs E. Effect of Gabapentin vs Pregabalin on Pain Intensity in Adults With Chronic Sciatica: A Randomized Clinical Trial. JAMA Neurol. 2019 Jan 1;76(1):28-34. doi: 10.1001/jamaneurol.2018.3077. Erratum in: JAMA Neurol. 2019 Jan 1;76(1):117. PMID: 30326006; PMCID: PMC6439871.

[9] Poppen H, Oehlke K, Van Klompenburg E. Weight Gain in Veterans Taking Duloxetine, Pregabalin, or Both for the Treatment of Neuropathy. Fed Pract. 2021 May;38(5):238-242. doi: 10.12788/fp.0111. PMID: 34177234; PMCID: PMC8221832.

[10] Drugs.com (24 December 2021) Lyrica vs Gabapentin: What’s the difference?

[11] University of British Columbia (19 Feb) Gabapentin and pregabalin: Are high doses justified?