Can Lyrica (Pregabalin) Cause Speech Issues?
Yes, Lyrica (pregabalin) can cause speech issues, specifically speech disorder, which occurred in 1-3% of patients in clinical trials, with higher rates at the 600 mg/day dose. 1
Evidence from FDA Drug Labeling
The FDA-approved prescribing information for pregabalin explicitly lists speech disorder as an adverse reaction in controlled clinical trials:
In postherpetic neuralgia trials: Speech disorder occurred in 0% at 75 mg/day, 0% at 150 mg/day, 1% at 300 mg/day, and 3% at 600 mg/day (compared to 0% with placebo) 1
In partial-onset seizure trials: Speech disorder occurred in 1% at 150 mg/day, 2% at 300 mg/day, and 7% at 600 mg/day (compared to 1% with placebo) 1
Related Cognitive and Communication Effects
Beyond direct speech problems, pregabalin causes several related adverse effects that can impact communication:
"Thinking abnormal" (primarily difficulty with concentration/attention, but also includes cognition and language problems and slowed thinking): occurred in 2-8% of patients across various doses 1
Confusion: occurred in 2-7% of patients, particularly at higher doses 1
Amnesia: occurred in 2-5% of patients 1
Dose-Dependent Relationship
The incidence of speech issues increases with higher doses of pregabalin, demonstrating a clear dose-response relationship. The 600 mg/day dose shows the highest rates of speech disorder (3-7% depending on the condition being treated), compared to lower or absent rates at 150-300 mg/day. 1
Clinical Implications
Speech issues are a recognized adverse effect of pregabalin and should be discussed with patients before initiating therapy 1
If speech problems develop, consider dose reduction as the effect appears dose-dependent 1
These effects were generally classified as "mild" to "moderate" intensity in most patients who experienced them 1
Speech disorder was among the adverse reactions that led to discontinuation in approximately 1% of patients in controlled trials 1