Pregabalin is a prescription medication primarily used to treat neuropathic pain, epilepsy (as an adjunctive therapy for partial-onset seizures), fibromyalgia, and generalized anxiety disorder (GAD) in adults. It’s classified as an anticonvulsant and analgesic, structurally similar to the neurotransmitter GABA but works by binding to the alpha-2-delta subunit of voltage-gated calcium channels in the central nervous system (CNS), reducing the release of excitatory neurotransmitters like glutamate, norepinephrine, and substance P. This calms overactive nerve signals.

Key Facts

Evidence of Effectiveness

• Neuropathic Pain: FDA-approved based on trials like those in New England Journal of Medicine (2005), showing 30–50% pain reduction in diabetic neuropathy and postherpetic neuralgia vs. placebo (NNT ~4).
• Fibromyalgia: Randomized trials (e.g., JAMA 2008) demonstrated significant symptom relief (pain, sleep, fatigue) at 300–450 mg/day.
• Epilepsy: Adjunctive therapy reduces seizure frequency by ≥50% in 20–40% of patients (Lancet 2005).
• GAD: European approval; meta-analyses (British Journal of Psychiatry 2013) show efficacy comparable to SSRIs, with faster onset.

Side Effects

Common (10–20% of users):

• Dizziness, somnolence, dry mouth, edema, blurred vision, weight gain.

Serious (rare, <1%):

• Angioedema, hypersensitivity reactions, suicidal ideation (black box warning for anticonvulsants), respiratory depression (especially with opioids—FDA warning 2019).

Warnings & Interactions

• Avoid abrupt discontinuation: Taper over 1 week to prevent seizures/insomnia.
• Renal Impairment: Dose adjust (80% renally excreted); contraindicated in severe cases.
• Pregnancy: Category C; increased malformation risk (APLAUD study data).
• Interactions: Potentiates CNS depressants (alcohol, opioids, benzodiazepines—risk of overdose). Avoid with strong CYP inducers? No, minimal hepatic metabolism.
• Abuse Potential: Euphoria at >300 mg; street value for “high” similar to benzos.

Alternatives

• Pain: Gabapentin (cheaper analog, less potent), duloxetine (SNRI), TCAs.
• Anxiety: SSRIs/SNRIs (first-line), buspirone.
• Seizures: Lamotrigine, levetiracetam.

Not medical advice: Consult a doctor for personalized use. Sourced from FDA labels, UpToDate, and peer-reviewed meta-analyses (e.g., Cochrane Reviews 2019–2023). If this is for a specific condition, provide more details for tailored info.