From the Guidelines
Pregabalin is primarily used to treat neuropathic pain, fibromyalgia, generalized anxiety disorder, and as an adjunctive therapy for partial seizures, with a recommended daily dose of 150-600 mg/day in divided doses 1. The medication works by binding to calcium channels in the nervous system, reducing the release of excitatory neurotransmitters and thereby decreasing pain signals and seizure activity. Some key points to consider when using pregabalin include:
- Starting with lower doses (25-75mg twice daily) and gradually increasing as needed and tolerated
- Common side effects include dizziness, drowsiness, dry mouth, edema, blurred vision, weight gain, and difficulty concentrating
- Patients should be aware that pregabalin may cause physical dependence, and abrupt discontinuation can lead to withdrawal symptoms, so it should always be tapered gradually under medical supervision
- It's essential to take pregabalin exactly as prescribed, avoid alcohol while using it, and inform healthcare providers about all other medications being taken to prevent potential interactions
- The most recent and highest quality study recommends pregabalin as a first-line treatment for neuropathic pain, with a number needed to treat (NNT) of 4.04 for 600 mg/day and 5.99 for 300 mg/day 1. The use of pregabalin has been supported by several studies, including a 2011 study published in Diabetes/Metabolism Research and Reviews, which found that pregabalin was highly effective in the treatment of painful diabetic peripheral neuropathy 1. Additionally, a 2020 study published in the Journal of Clinical Oncology found that pregabalin may be helpful in treating chemotherapy-induced peripheral neuropathy, although further confirmation is needed 1. A 2023 study published in the Mayo Clinic Proceedings also found that pregabalin may be effective in treating erythromelalgia, a condition characterized by burning pain in the hands and feet 1. Overall, pregabalin is a useful medication for the treatment of various types of neuropathic pain, and its use should be considered in patients who have not responded to other treatments.
From the FDA Drug Label
Pregabalin is a prescription medicine used in adults, 18 years of age and older to treat: pain from damaged nerves (neuropathic pain) that happens with diabetes pain from damaged nerves (neuropathic pain) that follows healing of shingles fibromyalgia (pain all over your body) pain from damaged nerves (neuropathic pain) that follows spinal cord injury Pregabalin is a prescription medicine used in people 1 month of age and older to treat: partial-onset seizures when taken together with other seizure medicines
The use of pregabalin (Lyrica) is for the treatment of:
- Neuropathic pain associated with diabetes
- Postherpetic neuralgia
- Fibromyalgia
- Neuropathic pain associated with spinal cord injury
- Partial-onset seizures in patients 1 month of age and older, as an adjunctive therapy 2, 2
From the Research
Uses of Pregabalin
- Pregabalin is used for the treatment of neuropathic pain associated with diabetic peripheral neuropathy and postherpetic neuralgia 3
- It is also used as adjunctive therapy for adult patients with partial onset seizures 3, 4
- Pregabalin is indicated for the treatment of partial epilepsy, generalized anxiety disorder, and neuropathic pain 5
- It has been shown to be effective in the management of neuropathic pain, refractory partial seizures, and generalized anxiety disorder 6, 7
Approved Indications
- Pregabalin is approved for the treatment of painful diabetic neuropathy and postherpetic neuralgia 3
- It is also approved for the treatment of epilepsy, generalized anxiety disorder, and neuropathic pain 6
- The licensed dosage range for pregabalin is 150 mg to 600 mg/day 6