Have you ever heard of pregabalin? In this article, we will tell you all about it as well as how it works.
Treatment with pregabalin has been shown to be effective in controlling neuropathic pain and in improving a patient’s quality of life. In this article, we will describe its effects in detail.
Pregabalin, also marketed as Lyrica, is an antiepileptic drug that is used in the treatment of neuropathic pain in disorders caused by diseases such as diabetic neuropathy or postherpetic neuralgia.
At present, neuropathic pain is one of the major medical challenges. This is due to its resistance to painkillers and our lack of knowledge about its underlying pathology.
What is pregabalin?
Pregabalin is a counterpart to gamma-aminobutyric acid or GABA. GABA is the primary neurotransmitter inhibitor in our central nervous system and its function is to slow down brain activity.
Although pregabalin is an antiepileptic drug, researchers also classify it in the field of neuromodulatory drugs. It originated from gabapentin, and was specifically indicated for peripheral neuropathic pain.
It is a drug with linear pharmacokinetics, which does not just vary individually. It does not bind to plasma proteins, it is not metabolized in the kidneys and our body excretes it through the urine. These traits mean that it has few interactions with other substances.
The analgesic properties of pregabalin begin to have an effect during the first few days of treatment and last for a long time.
Treatment with pregabalin
Pregabalin is used in the treatment of:
- Neuropathic pain. Doctors recommend pregabalin for the treatment of peripheral and central neuropathic pain in adults.
- Epilepsy. Doctors prescribe pregabalin in the combined treatment of partial seizures, with or without secondary generalization, in adults.
- Generalized anxiety disorder. This drug is also used in the treatment of generalized anxiety disorder (GAD) in adults.
Treatment with pregabalin has been shown to be effective in placebo-controlled studies, in a dose-dependent manner. This is because it controls pain, improves sleep and improves the quality of life in patients with neuropathic pain in many different ways.
It is particularly useful in the treatment of diabetic neuropathy or postherpetic neuralgia.
- Diabetic neuropathy. This is a disorder of the nervous system, caused by diabetes.
- Postherpetic neuralgia. This is a persistent, neuropathic pain, localized in the dermatome, where an acute case of shingles has previously occurred. We know that it lasts more than 3 months after the skin lesions have disappeared.
How does it work?
Pregabalin is a ligand of an auxiliary subunit of the voltage-gated calcium channels in the central nervous system. However, researchers do not understand exactly how it works and interacts.
Its analgesic effect is due to its ability to bind to this protein subunit better than gabapentin – another antiepileptic drug used against neuropathic pain and fibromyalgia in adults. Their pharmacological profiles are therefore similar.
Accompanying this subunit, this substance modulates how calcium iron penetrates the voltage-gated channels and, as a result, reduces the release of stimulating neurotransmitters such as glutamate, norepinephrine and substance P.
This reduces neuronal irritability in the various areas of the nervous system. This is especially the case with those cases related to pathologies with neuropathic pain, epilepsy or anxiety.
Although an analog of gamma-aminobutyric acid (GABA), it does not interact with GABA-A or -B receptors. It also does not affect the resume. Because of this, it cannot develop gamma-aminobutyric actions.
The most common adverse reactions with pregabalin are:
- Increased appetite
- Weight gain
- Euphoric mood
- Reduced libido
- Erectile dysfunction
- Blurred vision
- Double vision
- Disorders of the intestine
- Muscle cramps
- Pain in the back and limbs
Despite this list of possible side effects, we must emphasize that most of them are short-lived and well-tolerated by patients. The rates of dropout in treatment are minimal.
In some patients, withdrawal symptoms have been observed after cessation of treatment. For that reason, doctors recommend that patients reduce their dose little by little to avoid possible complications.