Pregabalin (Lyrica) is from a class of medications called anti-epileptics. It is used to treat patients with neuropathic pain (from damaged nerves) which may be felt peripherally in the hands and feet if it is from diabetic neuropathy. Examples of conditions that can cause central neuropathic pain include stroke, spinal cord injury and multiple sclerosis.
Pregabalin has been extensively tested in the short term and found to reduce pain and improve sleep in some patients with post-herpetic neuralgia and diabetic neuropathy. It has also been tested on patients with fibromyalgia (widespread pain syndrome) which is not a neuropathic pain condition. However, it has also been found to be beneficial in reducing the pain in some of these patients.
It may take several weeks before the dose has been increased (titrated up) enough to bring down the pain symptoms.
A significant proportion of people with neuropathic pain don't benefit from any single medication, even at maximum doses. Often combination drug therapy is used for neuropathic pain including anti-epileptics and tricyclic antidepressants (TCA). Using two or more medications may improve their pain relief effect as well as reduce side-effects if the medications are being used at lower doses.
Dizziness and drowsiness are the more common side-effects which may increase with higher doses. Blurred vision may also occur, and if affected by these side-effects don't drive or operate machinery. In the clinical trials these were the most common adverse effects causing people to stop taking pregabalin. However, more serious but less common side-effects may occur, including postural hypotension and arrhythmias which may be more commonly seen in older people.
Patients should not stop taking pregabalin without seeking medical advice. Stopping suddenly may cause symptoms such as: anxiety, insomnia, headache, nausea and diarrhoea.
Pregabalin has a similar pharmacological action to gabapentin. However, gabapentin is not on the Pharmaceutical Benefits Scheme (PBS) and so is not subsidised by the government for neuropathic pain.
For more information visit the National Prescribing Service website and see the Lyrica consumer medicine information (CMI).