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Pregabalin (lyrica) may cause physical dependence

  1. Terrapinzflyer
    A report in the current issue of Psychotherapy and Psychosomatics by a group of European investigators headed by Fabrizio Schifano (UK) has explored the potential for dependence of pregabalin using patients' online reports.

    Pregabalin is a prescription drug licensed to treat generalized anxiety disorder, partial epilepsy, and neuropathic pain. Pregabalin is structurally related to gabapentin and shares some therapeutic indications with clonazepam.

    However, both clonazepam and gabapentin possess an identified abuse potential, at least in selected populations. Between January 2008 and August 2010, qualitative Google searches of 203 websites have been carried out in 8 European languages using key words such as 'legal highs', 'research chemicals', 'online pharmacy', 'Lyrica', 'pregabalin', and 'online pharmacies'. Pregabalin was described as an 'ideal psychotropic drug' for recreational purposes to achieve specific mindsets, including: alcohol/GHB/benzodiazepine-like effects mixed with euphoria; to achieve entactogenic feelings and DXM-like disassociation, and to cope with opiate/opioid withdrawal. Misuse of pregabalin mostly seemed to occur orally, but intravenous, rectal ('plugging'), and 'parachuting' (emptying the content of the capsule into a pouch) self-administration techniques were also reported. Time of onset of the effects ranged between 10 min and 2 h, depending on the route of administration. Tolerance may reportedly develop fairly rapidly, and wear off quickly after drug cessation.

    Similarly, gabapentin seemed to possess both heavy sedative and psychedelic effects. Interestingly, however, one user argued that 'pregabalin outshines gabapentin. Far less dosage to achieve the same recreational high '. Similarly to pregabalin, drug tolerance could reportedly develop very rapidly. Conversely, clonazepam was reportedly inducing either sedation (at 1-2 mg) or stimulation (at more than 8 mg). Clonazepam was typically co-administered with different sedatives and/or psychedelics. Pregabalin, gabapentin and clonazepam were commonly offered for sale on the web, without the need of a prescription. One could wonder about the anxiolytic properties of pregabalin, gabapentin and clonazepam as potential mediators for misuse. In fact, some users might start self-administering with these GABAergic drugs as a way of self-medicating. Because of rapid development of high tolerance levels with both pregabalin and gabapentin, increasing dosages are self-administered. In line with observations presented in this paper, pregabalin is indeed characterized by higher (2.5 times) potency, quicker absorption rates, and greater bioavailability levels than gabapentin.

    One could wonder why both gabapentin and pregabalin, in apparent contrast with clonazepam, seem to possess both a sedative as well as a dissociative effect. Although all 3 compounds are GABAergic, the precise mechanism of action of pregabalin and gabapentin is still unclear. Conversely, clonazepam is a well-characterized, powerful, compound which seems to have replaced flunitrazepam as the most popular misused benzodiazepine. A better clarification of the pregabalin misuse potential level is of interest, since the drug has recently been proposed as a treatment for substance misuse, for both alcohol- and benzodiazepine-dependent individuals. The potential of misuse of pregabalin is not typically mentioned in the prescribers' aids. However, controlled clinical studies carried out in over 5,500 patients have shown that in some patient populations self-reporting rates of euphoria ranged between 1 and 12%. Abrupt/rapid discontinuation of pregabalin may be associated with insomnia, nausea, headache, or diarrhea, which may be suggestive of physical dependence.

    One of the most interesting findings of the present report is the dissociative effect noticed among pregabalin/gabapentin abusers and not in clonazepam abusers.


    May 9, 2011

    http://www.news-medical.net/news/20110509/Ideal-psychotropic-drug-may-cause-physical-dependence.aspx

    It should be noted that Fabrizio Schifano is well known to be biased against drugs/drug use and is one of those behind "The Psychonaut Project" and he publishes in this "journal" quite a bit...
    I will request the full paper in the medline thread

Comments

  1. Cara Somer
    I suffer from Depression and Anxiety and have NO problem with drugs if they work and do not cause permanent damage to my health. Having been prescribed this for anxiety and finding it made me WAY too sleepy (despite working well) and did require that I increase the dose after a few days, I read on several drugs websites including www.drugs.com, that Pregabalin can cause dementia, encephalopathy and permanent memory loss. Any comments?
    1. GypsyQueen13
      This is an anti-seizure/nerve pain medication. If ur being prescribed this for Depression/Anxiety then not only is it being done so "off-label" which means it hasn't been approved by the FDA for this purpose. It's classified as a controlled substance & can cause problems for ANYONE taking it for the aforementioned ailments. It can be EXTREMELY difficult to get off of & can/DOES cause major with WD if not weaned off of properly. PLEASE be careful with this drug since u are taking it for those purposes. It shouldnt have EVER been prescribed to u for those reasons!!! I'm not just blowing smoke (hehe) with regards to this information. I was on the highest dose possible per day for nerve pain & it was extremely difficult to get off of. It took me nearly 2 years to wean off of it completely. It was also prescribed to my step-mother for Depression & Anxiety and caused her a great many issues ranging from swollen hands/feet - disorientation, falling/clumsy/balance issues, along with several other problems.
      Personally I would stop taking it. There are a great many BETTER SUITED drugs that ARE FDA approved for the purposes u need it for.
      PLZ USE WITH CAUTION if u decide to stay on it!!
      Check out this link to the drugs website for better, more detailed info...
      https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=60185c88-ecfd-46f9-adb9-b97c6b00a553


      Good Luck
  2. GypsyQueen13
    *THIS DRUG WAS NOT APPROVED BY THE FDA FOR ANTI-PSYCH PURPOSES & CAN BE EXTREMELY DANGEROUS BEING TAKEN FOR SUCH PROBLEMS!!*
    This is an anti-seizure & nerve pain medication - those are the purposes it was FDA approved for.
    THERE ARE PLENTY OF BETTER QUALIFIED DRUGS THAT ARE FDA APPROVED TO TREAT THESE AILMENTS AND IF ANYONE IS PRESCRIBED THIS MEDICATION FOR DEPRESSION/ANXIETY/MOOD STABILIZATION REASONS THAN IT HAS BEEN PRESCRIBED "OFF-LABEL" WHICH IS NOT ONLY TECHNICALLY ILLEGAL BUT VERY NEGLIGENTLY DONE SO.
  3. usedtocare
    Note, this article refers to chemical dependency and makes no reference to addiction.
    I'm sure you know the difference.
    Pregabalin should not be discontinued abruptly as it increases the risk of seizures and can cause less serious but uncomfortable though transient discontinuation problems unless tapered from a moderate dose.
    Yes, the initial treatment sedation and subjective euphoria can lead people to misuse this medication but its unusual dose dependent bioavailability curve (lower at higher doses) as well as its rapid rise in tolerance to its pleasurable effects combined with an ld/50 in rats of 30mg/kg (or 30,000 mg or this 100 kg rat) makes for a much safer alternative to benzos if used recreationaly.
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