From the FDA Drug Label
Antiepileptic drugs (AEDs), including pregabalin, increase the risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Monitor patients treated with any AED for any indication for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior
Patients, their caregivers, and families should be counseled that AEDs, including pregabalin, may increase the risk of suicidal thoughts and behavior and should be advised of the need to be alert for the emergence or worsening of symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts, behavior, or thoughts about self-harm.
Pregabalin and Depression: Pregabalin may cause or worsen depression. The FDA drug label warns that antiepileptic drugs, including pregabalin, increase the risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Patients should be monitored for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior.
- Key Points:
- Pregabalin may increase the risk of suicidal thoughts or behavior
- Monitor patients for emergence or worsening of depression
- Counsel patients and their caregivers about the risk of suicidal thoughts and behavior 1
- The risk of suicidal thoughts or behavior was generally consistent among drugs in the data analyzed 1
From the Research
Pregabalin can cause depression as a side effect, and patients should be closely monitored for changes in mood, especially those with a history of depression or mood disorders. The most recent and highest quality study, 2, found that changes in mood, depression, and suicidal ideation can occur after commencing pregabalin for neuropathic pain, even in patients with a stable mood before treatment. Key points to consider include:
- Pregabalin has been associated with depression and suicidal ideation in some patients, with a reported frequency of 1-10% [ 2, 3 ].
- Patients with a history of depression or mood disorders may be at higher risk for experiencing these side effects [ 4, 5 ].
- The mechanism behind pregabalin-induced depression is not fully understood but may relate to its effects on neurotransmitters in the brain, particularly its action on calcium channels which influences GABA activity and other neurochemical systems involved in mood regulation [ 6 ].
- If symptoms of depression occur while taking pregabalin, such as persistent sadness, loss of interest in activities, changes in sleep or appetite, or thoughts of self-harm, patients should contact their healthcare provider immediately [ 2, 3 ].
- Healthcare providers may need to adjust the dose, switch to an alternative medication, or add treatments to manage depression if it occurs while taking pregabalin [ 4, 5 ].