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View Full Version : Is pregabalin worth it?



Lissa101
28-02-13, 23:00
My boyfriend has a psych nurse for his depression and he's been telling him about my problems with anxiety. His nurse said that I should try and get my GP to prescribe Pregabalin. I've been through three SSRI's already - Prozac, Sertraline and Citalopram. I know my GP will not appreciate me trying to prescribe this for myself plus I've heard it's expensive. So, is it really such a wonder drug and should I fight to try and get it?

xxx

Mark13
01-03-13, 01:51
I've tried 3 tricyclics, 3 SSRIs plus mirtazapine and trazodone.

Pregabalin helps me much more than any of those did.

It's not a wonder drug but it's taken about 50% of my anxiety away. By that I mean I feel only half as bad on pregabalin as without it.

It took a while to work for me, but it was worth it.

hanshan
01-03-13, 04:45
Pregabalin works differently from ADs (SSRIs) and benzodiazepines, so it's worth a try if these haven't worked or doctors won't prescribe them. It has low abuse potential, and can be taken long-term. The high cost is mostly because it is still under patent - it's probably not inherently expensive to manufacture.

It's licensed for Generalised Anxiety, and seems to work best for constant low-level anxiety. It doesn't seem to work very well for panic attacks.

It works very well for some people, moderately well for others, and not at all for some. The only way to find out is to try it.

The daily dose can go up to 600 mg per day. Most doctors seem to like to start off with a low dose, as some patients respond quite well at low levels. If it doesn't seem to be working, don't be afraid to make solid increases in the dose. Some people in trials have been given 400 mg or 600 mg per day from the beginning of the trial. A low initial dose, however, may help minimise side effects.

I've been taking pregabalin since 2010, and it's worked well for me. I'd say it has blocked about 85% of my previous anxiety, and what remains is normal and manageable.

steveo
01-03-13, 12:41
I was prescribed it 2 weeks ago by a consultant psychiatrist on the 16th of Feb. He also increased my Citalopram dose to 30 from 20. I've basically had a breakdown since the start of Jan. He assured I would start to feel better by thursday.
2 Weeks on and I dont really think I feel better. I'm on 75mg twice a day. I've also been told to only take it for a month.

I think prehaps it might be shaving the very edge of my anxiety but then again I've also been on diazapam constantly so I guess it's hard to say. But, for ME, it's not the wonder drug that I so hoped it would be.

I'm about to call him up now. I think I have a right to after paying £240 to see him.

Lissa101
01-03-13, 13:14
Thanks for your replies guys, its gave me a lot to think about.

Steveo - I had a breakdown last June and was slowly getting better but have felt on the verge of another one since xmas. Did you just see a psychiatrist on a one-off basis? I can't afford a regular psychiatrist but was thinking of getting a single appointment for advice on meds. My GP is just changing me from one SSRI to another and I've had enough of side effects and withdrawals

steveo
01-03-13, 13:25
Yeah it was a one off basis. My mum had to pay. I saw him for less than 40 mins! I'm trying to call him today to let him know that I don't feel any better.

I've had anxiety since I was 6, I'm 28 now. In my opinion GP's aren't specialised enough in mental health medication. Everyone is either put on Citalopram or Prozac. One of the other. A psychiatrist is trained purely in that area only.

I saw a Consultant psychiatrist (supposed to be the top dog) and I feel no better though. Since then I've had to move back to Cornwall to live with my dad as I need looking after right now. My mum is willing to pay for me to see one down here.

I might PM you if that's ok.

bernie1977
01-03-13, 13:38
You can access a psychiatrist on the NHS. As you say they are much more knowledgable about the medication. Steveo I do feel that after all you have been you through you should ask your GP for a referral it is your right. When I first saw one he sorted out my meds and also set up a treatment plan which included me getting a CPN for home visits and a support worker to help get me out as I'm agoraphobic.

Lissa101
01-03-13, 14:24
My GP told me very firmly that these days services are so tight that psychiatrists are only for people with 'serious' mental health problems. I'd just told him that I was suicidal. Not serious enough! That was months ago and I seriously think i would have recovered quicker if I had seen one.

steveo
01-03-13, 15:06
Well In Cardiff I was brushed off with Diazapam and citalopram and however many times I rang my GP he just said TAKE DIAZAPAM. YOU'LL BE FINE.

So I had no choice but to pay for a psyc.

I'm now in Cornwall being looked after by my dad and he registered me with the local GP and the CRISIS team have already been on the phone to me and we have an appoinment on monday. Im going to see what services are available for me through them.

I'm not in a good place right now though and I'm heavily crushed that I was assured the pregabalin would make me feel better.

clio51
01-03-13, 15:13
I see a nhs consultant psych, and also have a mental health social worker,and a cbt therapists.
All nhs.

I too was going through a bad patch with suicidal thoughts this is when I went to see the psych and she changed my med from cipralex to venlafaxine.
Tbh through they do have more med knowledge but I still think it's a case so try this and see. And when you won't answers to questions regarding meds it so hard to get a reply from them because they so busy and mine only work's 4 days. You get a quicker answer back from your go.

steveo
01-03-13, 15:18
Just spoken to my psyc.

He told me to stop the pregabalin and increase my dose to 40mg Citalopram!

Another few weeks of getting worse before I get better.... Im skeptical......

Lissa101
01-03-13, 15:33
I could only stick Citalopram for a week - I felt like I was living in the twilight zone. Was totally wide-eyed and strung out. Do you know why he advised to stop the Preg?

steveo
01-03-13, 17:52
Because I told him that I don't feel any different. He said it would help but I don't think it has. I think it's helped me sleep at night but I'm getting the worst vivid dreams imaginable. Sometimes I dream as soon as I close my eyes and can hear things and it's very scary.

I'm skeptical of just stopping this medication though and even more skeptical about once again changing my dose of Citalopram to the max! Not sure I'm going to follow his advice,

---------- Post added at 16:52 ---------- Previous post was at 15:04 ----------

I just rang my GP for a second opinion about this. She told me that shes never ever prescribed Pregabalin for this sort of this as it's unlicensed for anxiety and quite frankly experimental. She said if it was going to work then it should of worked sooner.

Apparently I should experience no issues coming off the medication after only being on it for 2 weeks at 150mg a day. Can anyone back me up on this one?

hanshan
02-03-13, 03:03
Steve,

Everything your GP said is incorrect.

- Pregabalin has been licensed for General Anxiety in the EU and UK since 2006. Seven years! How long does it take a GP to catch up?

- It's not experimental. Clinical trials have been conducted and published showing pregabalin's efficacy for anxiety. Unfortunately, not everyone responds, which is true for most classes of psych medicines. In that sense, prescribing any psych medicine is "experimental".

- It doesn't work straight away for everyone. It can take up to a month for full effect for some people, with a daily dose of 400 mg+.

- There are no guarantees about discontinuing after two weeks. If you feel worse, it may mean that it is having some positive effect.

- Information concerning pregabalin and anxiety can be found on the internet. Print out some from a reputable site (eg NHS) and give it to your doctor.

- It's not the psychiatrist's fault that pregabalin did not work, but he was wrong to give you the impression that it was a certainty. As you said, you initially felt better just seeing him. That's the placebo effect working, but then came the backlash.

- If the side-effects start to fade, a higher dose of pregabalin (eg 400-600 mg per day) MAY (no guarantees here) have some noticeable positive effect.

little wren
02-03-13, 07:48
My GP told me very firmly that these days services are so tight that psychiatrists are only for people with 'serious' mental health problems. I'd just told him that I was suicidal. Not serious enough! That was months ago and I seriously think i would have recovered quicker if I had seen one.

I would seriously consider a different GP at the surgery! Psychiatrists are not only for serious mental health problems (serious in this context is psychosis, bipolar etc rather than neurosis - anxiety problems).

It does depend how severe the neurosis is - how much it is affecting your life etc. I just think (my pennies worth) that after three ssri attempts it seems you have adequately shown that ssri's are not a suitable group of anti-depressants for you. Hope it works out x
ps I am only just starting out on pregabalin at a low dose and building up (I go up to 180mg today).

steveo
02-03-13, 10:16
Citalopram worked extremely well for me the first time round. It gave me my life back.

My only problem was that I came off the drugs because I was feeling so well but it seemed that caused all my problems to return ten fold.

This GP at this surgery gave me more time and empathy than not only any GP i've dealt with before, but also than the psychiatrist whom I paid £240 to see who barely looked at me once and asked very few questions. The appointment with him would of been about 20 minutes if I hadn't asked so many questions.

The psyc brushed me off with 75mg twice a day for only a month and to up my SSRI.
He didn't want to see or hear from me again. He didn't explain that pregabalin could take up to 4 weeks on a higher dose to be of some use. He didn't explain it would make my depersonalisation WORSE which is my main problem, due to the spaced out feelings pregabalin can give you.

Yes this breakdown I'm in is very severe but Im aware I haven't given my orignial SSRI long enough. He only put me on Pregab temporaily to try and combat the effects of getting it into my system.

Something my GP did down here in Cornwall and NO OTHER GP and no advice from the pysc, is put me in touch with the local CPN who contacted me STRAIGHT AWAY and are seeing me on monday first thing. So rather than brush me off with meds, I've been now given a full package of care. I begged for this in Cardiff and I asked the pscy if I needed any extra help from anywhere and he said no you'll be fine.

I thought long and hard before phoning my psyc to tell him that I felt no different. I tried to really really think, 'Had the tablets made a difference??'

I think to give them there due, I believe they shaved the edge of my anticipatory anxiety and made me calmer, but at the price of causing my depersonalisation and confusion to be worse.

So for me and for those reasons I'm very angry with that over paid psyc who I felt brushed me off, and I'm very happy with my new GP surgery down here and very much look forward to a full package of care.

I'm genuinely very happy for everyone on here who found this to be a wonder drug.

hanshan
02-03-13, 13:11
Hi Steve,

My experience with pregabalin is that over time it fades away into the background so you are not aware of it. If you feel it may be doing some good, it may be worth persisting to see if the depersonalisation decreases. This is not a given - rather, balancing the possibilities.

Good luck with it all. You sound like you are in a better part of the world to deal with it all.

steveo
02-03-13, 15:31
I could of only had them for another 2 weeks unless I told the GP that they changed my life completely.

I already feel more connected with the world albeit very anxious today but I've been bed bound for a few days now so not much different.

Mark13
02-03-13, 22:01
My experience with pregabalin is that over time it fades away into the background so you are not aware of it.
Well put hanshan.

I only notice how much it's helping when I miss a dose :ohmy:

Pity about the sexual side effects but sometimes you have to make sacrifices to feel better.

stevo - my Doc said the same thing to me about fluoxetine (I'd been on it for 2 weeks at the start dose). I know it's a different drug, but you are on the usual start dose.

You shouldn't get any withdrawal effects, the drug has a very short half-life and AFAIK should be out of your system in about 12-24 hours.

If it is doing you some good, you should notice yourself getting worse within a day (within hours for me). If that happens it's likely that you were actually benefiting from the drug, rather than it being any withdrawal symptoms.

To be fair to GPs, even though this drug has been licensed for GAD since 2006, it's so expensive it's rarely prescribed for GAD. That's probably why some Docs aren't aware of it's use in anxiety.

hanshan
03-03-13, 08:32
Hi Steve,

Hope things go well with the appointment on Monday.

Hi Lissa,

This thread seems to have taken on a life of its own. I hope it's helpful for you - there's more here than you'll ever see in a patient information leaflet on pregabalin.

Lissa101
03-03-13, 10:21
Yep, its been very helpful. I'm a bit worried about it causing depersonalization as this was my absolute worst symptom and I still have it when anxiety is high. Also, has anyone found it impairs cognitive function? I'm studying and it's already hard enough to focus and concentrate.

x

steveo
03-03-13, 11:43
I don't think this thread went off on too much of a tangent. It still discussed the core question which was, is pregabalin worth it. For me it wasn't. I felt more disconnected with the world which worsened my already bad DR/DP and my cognitive function was terrible. I would prehaps say that it might of numbed the very tip of the iceberg off my anxiety but, I didn't feel like me at all. Plus, as I was only due to take it for one month to get myself used to the 30mg dose of Citalopram, then I figured I'd just rather keep taking diazapam to get over any anxious times.

For others though, I hear it works wonders and people feel benefits straight away. I think after a week you will know if it works for you. I came on this section of the forum before I tried the medication and unlike the SSRI threads, I mostly read incredible reviews of the drug, so I came INTO it on a positive note. I remained positive for a week despite feeling worse on the medication. After 2 weeks I was worse than what I originally was.
Maybe if I stuck it out for the long term and reached a higher dose, then maybe I too, would be one of the people praising this medication. For for the dosage I was on, and for only a months use, for ME, no, Pregabalin is not worth it.

I REALLY TRUELY hope that it does work for you though! I hope we all find that medication that fits right with us and helps to take the edge of this nightmare called anxiety and or depression.