From the Research
Lyrica (pregabalin) is a viable treatment option for generalized anxiety disorder, with recent evidence suggesting its efficacy and safety as a first-line therapy 1.
Key Points to Consider
- The most recent and highest quality study, a meta-analysis published in 2025, found that pregabalin demonstrated superior efficacy in reducing anxiety symptoms compared to other treatment options, including benzodiazepines, SSRIs, and SNRIs 1.
- Pregabalin has been shown to be effective in reducing anxiety symptoms, with a rapid onset of action and a favorable adverse event profile compared to other anxiolytic agents 2, 3.
- However, it is essential to consider the potential risks associated with pregabalin, including the risk of dependence, addiction, and withdrawal symptoms, particularly when used long-term or in high doses 4.
- The optimal dosage of pregabalin for the treatment of generalized anxiety disorder is typically in the range of 150-300 mg per day, divided into two or three doses, with gradual increases as needed and under close monitoring by a healthcare provider.
- Common side effects of pregabalin include dizziness, drowsiness, dry mouth, and weight gain, and patients should be aware of the potential for interactions with other medications that cause sedation.
- While pregabalin is FDA-approved for generalized anxiety disorder in some countries, its use for anxiety in the US may be off-label, and healthcare providers should carefully evaluate the benefits and risks of treatment and monitor patients closely.
Important Considerations for Clinical Practice
- Pregabalin may be a suitable option for patients who have not responded to or cannot tolerate other anxiolytic agents.
- Healthcare providers should be cautious when prescribing pregabalin, particularly in patients with a history of substance abuse or dependence, and should closely monitor patients for signs of withdrawal or dependence.
- The use of pregabalin for the treatment of nightmares, particularly those related to anxiety disorders or PTSD, may be considered, although the evidence for this indication is less robust compared to its use for generalized anxiety disorder.