Pregabalin vs Gabapentin, Adverse Effects, Risks & Treatment

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.

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:

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.

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

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

FAQs

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 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.

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.

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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