For many, pregabalin has had a profoundly positive impact on their lives. It eases the uncertainty and disruption to life caused by epilepsy, provides relief to chronic or debilitating neuropathic pain in fibromyalgia patients, and brings comfort to those suffering from generalised anxiety disorder.
Developed in the 1990s and brought to market in 2004 by the pharmaceutical giant, Pfizer, pregabalin was hailed as the successor to gabapentin, a similar anticonvulsant drug meant to treat the same range of conditions with the addition of fibromyalgia and neuropathic pain. (Lawrence). It’s sold under the brand name Lyrica, and by 2020, it was the 78th most-prescribed drug in the US with just over 9 million prescriptions issued for that year (“The Top 300 of 2020”).
Unfortunately, like so many other life-bettering drugs, pregabalin has serious potential for abuse; and if a drug can be abused, it will be. A 2017 article in The Guardian described pregabalin as ‘the new Valium’ as it was mentioned on 111 death certificates registered in England and Wales in 2016, prompting a reclassification of the drug as a class C controlled substance, meaning patients couldn’t simply obtain repeat prescriptions anymore (Marsh).
While pregabalin doesn’t come close to the mortality rate or societal damage of other drugs such as heroin or other opioids, cocaine, or alcohol, its still-rising abuse rates and ease of availability on the internet are cause for concern and a good enough reason for healthcare providers to understand the workings and effects of this drug in greater detail.
Pregabalin is classified as an anticonvulsant used for the treatment of both chronic and acute pain in patients suffering from fibromyalgia and neuropathic pain. It‘s also indicated as adjunctive therapy for the treatment of partial-onset seizures and postherpetic neuralgia.
Pregabalin is a GABA neurotransmitter analogue; however, it does not bind to the GABA receptors or the benzodiazepine receptors, nor does it have an acute effect on GABA uptake or degradation. Instead, it increases the density of GABA transporter proteins, thus increasing the rate of functional GABA transport (Parke-Davis Div. of Pfizer Inc). This increased GABA transport leads to a calming effect as it slows down neuron activity, effectively acting as a pair of brakes on your brain’s nerve system and reducing feelings of stress and anxiety in the process.
Increased concentrations of pregabalin in the brain can cause a high, and a study of over 5500 patients found that 4% of Lyrica patients reported euphoria as an adverse reaction, with this rate going up to 12% in some patient populations (Parke-Davis Div. of Pfizer Inc).
Like nearly all other substances that are habit-forming or prone to abuse, prolonged use of pregabalin (prescribed or not) will eventually lead to both the rebound effect and the opponent-process effect coming into play. These two processes help us understand how we become physically addicted to substances, and you can learn more about these phenomena in our article on Drug Withdrawal Symptoms, Timelines & Treatment.
The general medical consensus is that pregabalin is a safe drug to use when prescribed and taken as indicated. It has very few contraindications, with the manufacturer only indicating hypersensitivity to any of its components and angioedema as reasons to avoid it. Pregabalin becomes a problem when it’s no longer used as indicated, for example, when a person self-diagnoses a condition and seeks out pregabalin as treatment, or when someone increases their dosage in an attempt to get high. In these situations, one might experience any of the following symptoms at a wide range of intensities. The exact effect will vary between individuals and be affected by the dosage, length of use, and presence of other narcotics or substances.
When taken in large doses (>300mg per day), pregabalin can induce a sense of well-being and euphoria. It’s common knowledge that many people chase this feeling, which is a significant contributor to it being abused by people without a prescription.
By slowing down brain nerve activity, individuals feeling stress, anxiety, or other emotional issues find relief in pregabalin. This may contribute to the number of people who abuse pregabalin as it can act as a cheaper or more attainable alternative to prescription anti-anxiety medication.
Pregabalin can cause drowsiness and sedation. This could be a desirable effect for people who suffer from insomnia or other sleep problems.
The euphoria, antianxiety, and sedative effects mentioned above don’t come without a price. Admittedly, deaths attributed solely to pregabalin abuse are exceptionally rare and difficult to track (Addiction-SSA), but that being said, there are definitely known and confirmed dangers of prolonged pregabalin abuse. The table below shows the most commonly reported effects of pregabalin abuse; however, it is nowhere near an exhaustive list. We can separate these effects into physical and psychological effects.
Pregabalin is often abused alongside other substances, particularly opioids. These drug cocktails can enhance the effects of both substances, resulting in higher and more intense psychogenic (high) effects. Some of the most common substances that pregabalin abusers turn to include alcohol, benzodiazepines, zopiclone, cannabis, opioids, and amphetamines (Lancia et al.). Mixing prescription drugs with narcotics or alcohol is considered extremely risky behaviour among medical practitioners, as drug abusers often aren’t aware of potentially harmful or fatal interactions between the substances.
In a nutshell, pregabalin withdrawal symptoms typically start presenting anywhere within the first 24 hours after the last use, with most symptoms tapering down after around 48 hours. Withdrawal symptoms can include many of the symptoms most commonly associated with general drug abuse, including agitation, sweating, anxiety, and in extreme cases, hallucinations, and seizures. Medical care usually involves tapering a patient off pregabalin over a period of time as determined by the attending physician (Ishikawa). Feel free to read more about pregabalin withdrawal, treatment, and recovery in our prescription drug article.
Gladstones Clinic has been helping people overcome addictions and substance abuse since long before pregabalin was first brought to UK shores. Over the years, we’ve experienced a steady increase in the number of patients seeking help with beating pregabalin addiction, in line with the studies that indicate increased abuse.
We take pride in the work we do, and we’re happy to say that our highly trained and experienced addiction specialists can help anyone seeking to rid themselves of substance addiction using medically-backed and time-proven therapies and techniques. We take the time and effort required to understand our patients’ root causes of addiction before developing personalised strategies to deal with all factors of their addiction.
Our well-suited residential rehab facilities, located in London and the Cotswolds, have everything you could possibly need to go through drug withdrawal as easily and comfortably as possible and receive top-notch primary care from compassionate and understanding addiction specialists.
If you or a loved one are struggling with pregabalin (or other substance) addiction, please reach out to us. We are confident that Gladstones Clinic has what it takes to be your long-term, once-and-for-all partner in recovery.
Addiction-SSA. “Misuse and Abuse of Pregabalin “Current Issues in Prescription and Over the Counter Medicine Abuse, Misuse and Dependence. .”” Society for the Study of Addiction, 9 November 2018, https://www.addiction-ssa.org/images/uploads/Van_HoutMC_Pregabalin_And_Gabapentin_1230_Fri_9_Nov_2018.pdf. Accessed 2 August 2023.
Ishikawa, Hayahito. “Pregabalin withdrawal in patients without psychiatric disorders taking a regular dose of pregabalin: A case series and literature review.” Neuropsychopharmacology reports, vol. 41, no. 3, 2021, pp. 434-439. National Library of Medicin, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8411313/. Accessed 02 08 2023.
Lancia, Massimo, et al. “Pregabalin Abuse in Combination With Other Drugs: Monitoring Among Methadone Patients.” Psychiatry, vol. 10, 2019. Frontiers in Psychiatry, https://www.frontiersin.org/articles/10.3389/fpsyt.2019.01022/full. Accessed 02 08 2023.
Lawrence, Croom. “How Gabapentin Differs From Pregabalin.” Pharmacy Times, 22 September 2015, https://www.pharmacytimes.com/view/how-gabapentin-differs-from-pregabalin. Accessed 1 August 2023.
Marsh, Sarah. “Pregabalin, known as ‘new valium’, to be made class C drug after deaths.” The Guardian, 21 September 2017, https://www.theguardian.com/society/2017/sep/21/pregabalin-new-valium-class-c-drug-deaths. Accessed 2 August 2023.
Parke-Davis Div. of Pfizer Inc. “Lyrica – pregabalin.” DailyMed.nlm, NIH, https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=60185c88-ecfd-46f9-adb9-b97c6b00a553&type=display#section-18. Accessed 02 08 2023.
“The Top 300 of 2020.” ClinCalc, 12 September 2021, https://clincalc.com/DrugStats/Top300Drugs.aspx. Accessed 2 August 2023.