Stopping pregabalin

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Pregabalin
 

Pregabalin is used for the treatment of social anxiety disorder, as an add-on therapy with partial seizures, generalized anxiety disorder, neuropathic pain, and insomnia. The symptoms of stopping pregabalin are mild to moderate and resolve within one week after the discontinuation of pregabalin.

This topic highlights the importance of cautious monitoring of withdrawal symptoms during the period of tapping, and what are these symptoms?.

 

Pregabalin results in anxiolytic effects

through binding to a kind of receptors that prevent calcium influx to the cell and reduce the release of excitatory neurotransmitters.

Another predicted mechanism of action is that pregabalin resembles the inhibitory neurotransmitter called gamma-aminobutyric acid (GABA).

 

Pregabalin has a very high oral bioavailability with almost all the dose absorbed. pregabalin is eliminated by the kidneys with nearly no metabolism. Pregabalin has no significant interactions with other drugs.

 

The half-life of pregabalin is 5.5-6.7 hours, independent of dose and repeated dose administration. The most common dose-related adverse effects of pregabalin include dizziness, somnolence, and peripheral edema.

Stopping pregabalin

The symptoms of stopping pregabalin

have been reported in few case reports. One of them published in 2018 about a 62-year-old white female with a medical history of fibromyalgia, pancreatitis, migraine, general anxiety disorder, rheumatoid arthritis, cervical disc diseases, asthma, and unspecified depressive disorder was admitted to hospital with complaints of chest pain, insomnia, increased fearfulness aches, worsening of anxiety, diffuse body tremors, and extreme weakness of legs, dyspnea, palpitations, and dizziness. These symptoms started after stopping pregabalin by tapping the dose over several weeks.

 

The common symptoms of stopping pregabalin as reported in these cases are:

  • diaphoresis
  • tachycardia
  • hypertension
  • tremors
  • diarrhea
  • agitation
  • paranoia
  • auditory hallucinations
  • mutism
  • self-mutilation
  • suicidal attempt

 

The mechanism of these symptoms

is similar to benzodiazepine and ethanol, where discontinuation increases the production of the enzyme responsible for producing GABA.

 

DEA (Drug Enforcement Administration) has classified Pregabalin as a schedule V drug due to its potential for abuse. Tapping a dose of Pregabalin is associated with an increased risk of delirium and confusion. The tapping should be gradually over one week to decrease the chance of withdrawal symptoms.

 

A recent study

showed that most people weren’t aware of how pregabalin can be addictive and what are the adverse consequences of its abuse.

 

In recent years the abuse of pregabalin has been increasing rapidly. The users reported some symptoms associated with it like euphoria and feelings of dissociation when they exceed normal therapeutic dosages.

 

A study published in Emergency Medicine Journal reports an increase in the number of emergency cases admitted with causes related to Pregabalin abuse. Most cases presented with seizures, some of them required intubation and ventilation before admission to the Icu. There is also evidence that pregabalin interacts with some opiates such as heroin and can lead to death due to overdose.

 

Complications of withdrawal symptoms:

 

Dehydration and electrolyte imbalance can occur due to prolonged diarrhea, nausea, vomiting, and increased sweating. Life-threatening heart problems can also occur with pregabalin withdrawal so if you have rapid heartbeats or palpitation, seek medical intervention.

If pregabalin is used as anti seizures, abrupt discontinuation of it can exacerbate seizures and lead to recurrence seizures which can be an emergency.

Rapid pregabalin stopping can lead to cravings and relapse, which can push the users to overdose.

Depression and suicidal thoughts are common psychological withdrawal symptoms.

 

Treatment of pregabalin addiction

 

Stopping pregabalin can be a serious problem for people who become addicted to it.

 

Addiction treatment criteria are different from person to person.

 

Treatment includes the following:

  • Detox facilities: clinics where the abusers receive a safe detox period under professional medical supervision by a precise detox program.

Medical and Professional Counseling provides support during the whole duration of detox and monitors people for risks or complications.

 

  • Inpatient treatment: patients are admitted to these units for 28 days to 3 months where they attend intensive groups and individuals besides medical and psychiatric treatment. The facility provides a safe and structured environment.

 

  • Outpatient treatment: pregabalin abusers can receive support without the need to admit it, this support includes recovery programs allowing the patient to continue his normal activities and quarantine top-quality treatment in both group and individual therapy sessions.

 

  • Partial hospitalization: This situation gives the patient the advantages of the outpatient program and allows them to continue normal daily activities with more time commitment than outpatient treatment.