From the FDA Drug Label
Increased Risk of Adverse Reactions with Abrupt or Rapid Discontinuation [see WARNINGS AND PRECAUTIONS (5.6)]
The potential side effects of drastically lowering the Lyrica (pregabalin) dose include an increased risk of adverse reactions. It is recommended to avoid abrupt or rapid discontinuation of the drug. Instead, the dose should be gradually tapered to minimize the risk of adverse reactions. The exact side effects that may occur with a drastic dose reduction are not specified, but it is clear that careful dose adjustment is necessary to ensure safe use of the medication 1.
From the Research
Abruptly reducing Lyrica (pregabalin) dosage can cause withdrawal symptoms that may include headaches, insomnia, nausea, diarrhea, anxiety, dizziness, and in severe cases, seizures. These effects occur because the body becomes dependent on pregabalin's action on the central nervous system, particularly its effects on calcium channels and neurotransmitters like GABA 2. When the medication is suddenly reduced, the nervous system can become hyperexcitable as it adjusts to functioning without the drug. The severity of withdrawal symptoms typically depends on the original dose, duration of treatment, and how quickly the dose is reduced. Some key points to consider when reducing Lyrica dosage include:
- The potential for withdrawal symptoms, which can be severe in some cases
- The importance of gradual tapering to minimize withdrawal symptoms
- The need for medical supervision when reducing or stopping Lyrica, especially for patients taking it for seizure control To minimize these effects, Lyrica should be tapered gradually over at least one week, or preferably longer for patients who have been on higher doses or taking it for extended periods 3. Patients experiencing withdrawal symptoms should contact their healthcare provider immediately, as the tapering schedule may need adjustment. Never stop or reduce Lyrica without medical supervision, especially if taking it for seizure control, as this could trigger dangerous seizure activity. It's also worth noting that pregabalin has been shown to have a positive effect on sleep disturbance associated with several different clinical conditions, and its withdrawal may exacerbate sleep problems 3. Overall, the decision to reduce or stop Lyrica should be made under the guidance of a healthcare provider, taking into account the individual patient's needs and medical history.