View Full Version : Pregabalin with an antidepressant
Hi
I have just joined today, so I hope I am doing things right:huh:
I have been off work for about 11 months diagnosed with GAD / Major depression. I tried quite a few antidepressants, but they seemed to make me agitated and could not sleep and still had a constant stream of worring thoughts especially about losing my job, which is still a possibility. I have also started psychodynamic therapy, but feel stressed to hell when I come out:mad:, which lasts for a few days after. I have spent time on the net in desperation looking for a med that could give me some breathing space to be calm enough to be social and start work again. I suggested to my Psy Doc that pregabalin would be worth a go as my GP originally would'nt prescribe it. I will be starting 75mg at night and worried about the effects it has on cognitive functioning as I need to be on the ball in my job. Do the sleepy / groggy effects wear off soon. I had something similar I think when I tried Mirtazipine. I would also like opinions if it would be a good idea to see if an antidepressant would work alongside as I am aware that pregabalin is not an antidepressant
Best whishes all:)
AceOfSpades
28-06-13, 13:59
Hi funkyman
First of welcome to nmp
I have been on Pregabalin for 18 months now and the side effect wore off pretty quick and with you only being on 75mg at night I would not think the side effects would be that bad.
I am on 375mg and also Prozac (10mg but increasing that to 20mg this weekend) and also Diazepam (as and when needed).
You right Pregabalin is not an antidepressant but it is licenced for us on mild to moderate GAD and it does work well but since I have added Prozac to the mix even at a low dose I feel on top of the world I can do nearly everything I could do before hand.
Good Luck
Hi Funkyman welcome to pregabalin:)
75mgs at night only? I wouldn't think that would make you too groggy but it works differently on each person. You just have to try it and see. 75mgs is a small dose so any side effects should wear off pretty quickly.
Sarah
Hi to Sarah H and AceofSpades. Lovely to have the welcome and the advice. I think the Psychiatrist is starting me low as so far I have had some bad expereinces with various meds. At my next appointment I will ask about a combined approach. I think with the Anx and depression its like chicken and egg. But with every antidepressant I have tried I have still remained anxious even though I was led to believe they would sort both.
Thanks again:D
Hi Funkyman
Welcome to the forum.
I was on Mirtazapine (15mg), and had been for 5 years before I added pregabalin.
Those worked well together for a few months for me.
I had the odd memory lapse but nothing major, and I felt more invigorated and upbeat on it - could wait to get out of the house every day.
When I started on duloxetine (my current AD) I barely got out of bed for 3 days, so pregabalin was much easier on the SEs.
Just to chime in with my very limited experience so far... as Sarah has said, it is different for everybody. Some people can take it and have minimal sleepiness, whereas for me, Im just about at 25mgs twice a day and it really makes me tired/ zoned out. Im only a few days in though so im sure that will pass.
Because I feel less anxious, I actually feel much more on the ball in my job. I haven't noticed any cognitive impairment, but I feel much more relaxed in my social interactions, which makes work life so much smoother than before.
I combine pregabalin 600 mg with mirtazapine 45 mg daily. I think combinations with other ADs are not uncommon.
Good luck with pregabalin. Hopefully it will be the med you were looking for.
Hi to Eldimoni and Hanshan
Thanks for sharing your expereinces. I am now 2 days in and took the meds at about 10.00pm 75mg and felt spaced out at 10.00am this morning. Did not want to get up, but boss rang so soon shocked me into awake mode:ohmy:. 11.30 and feel like I have a slight hangover and feel sluggish. I was like this at the start of Mirts some time back and dont like the feeling of losing control, so really hope it does not take long to pass. I have a 2 week window to get my self back on track for the start of a phased return to work. I was hoping to get up to a higher dose sooner and get over the fog issues before returning as being away for nearly a year is stressful enough without thinking I will fall asleep in front of clients when advising:wacko:. Just concerned that I will get used to this months dose of 75 and then when I am back and its taken up to 150 say I will be in zombie land again. Not sure if I should ask the Psy doctor about a crash test !!
I am really hoping as you say hanshan, that it has the effect of not letting churned up emotions and anxiety get in the way of interacting with others, since in effect thats what I am paid to to and more or less, why I ended up getting sick. Whats peoples views on it helping to regulate emotions and keep things in perspective in the work place espeacially
if you have issues with percieved criticism:unsure:.
Kind regards all
My job is tertiary teaching, but during 2001 - 2006 I was given a supervisory position, which I'm really not suited to. This was before I started pregabalin in 2010. Eventually, the stresses of being a supervisor led to me giving up my supervisor position at the end of 2006, and I went back to teaching part-time.
Since 2010, pregabalin has made a big change for me - I feel more confident and relaxed dealing with people, which has led to me going back into the full-time workforce and taking on a job in Japan.
Hi Hanshan
I have a similar job and it revolves around helping dissafected teenagers 16-19 and need to feel confident and in better control of fear emotions, specifically fear of failure. Having gone from the most expereinced adviser in my local area (20 years), to someone who felt they no longer had what it takes I am hoping the drug will help combat some of the fear element, as well as percieved paranonia of what work colleagues will make of me. I am also hoping to get some therapy called mindfullness CBT, as the Psychodynamic therapy sent my anxiety into overdrive.:huh:
Thanks again
Hi Funkyman,
I hope pregabalin plus the therapy works for you. You can only try it and see. I can understand the stresses of dealing with teenagers. I know in teaching the way of relating to the students keeps shifting focus as I continue to get older, but they stay the same age.
Hi
Hanshan. Yes I agree I am less in touch with clients than I used to be.
Anxiety is going through the roof today as I have meeting with my boss tomorrow at home and worried that this low dose will not help with starting back. I think if it were not for financial burdens, I wonder would I be better not returning as the changes etc lead me to being sick in the first place, but the longer I am off the greater the anxiety about returning. At the same time another part of me says I shoulf be lucky to have a job and just get on with it.
Even after 3 days on the Pregabalin at 75mg I feel spaced out until well into the afternoon and if I am honest a little low on mood as well. I am waiting for the Psychiatrist to call for advice. Also feel a little paranoid as over the year not one colleague has sent a message to see if I am ok
Sorry for the rant, feeling sorry for myself today
Just concerned that I will get used to this months dose of 75 and then when I am back and its taken up to 150 say I will be in zombie land again.
funkyman
I went from 150 a day (2x75) to 600 (2x300) over 5 weeks, and the increases only brought me benefit, not a recurrence of earlier SEs.
YMMV of course :)
Hi Mark
Thanks for that, have you had expereinces of using it while in the workplace. I am not so great with memory and concentration at the best of times and spend all day actively listening to people in my job. Just worried they might need to be nudging me awake or me not being able to hold a meaningful conversation for long:wacko:. My own conclusions for my experimentation into the world of 'helping drugs' so far this year is that they have felt like some kind of speed:scared15: and caused me to be short tempered, irratable, insomnia, jitters, stomach churning (ssri's, Snri's etc). or the opposite stare into space, low mood, sleepy, drunk, slow, wont go outside etc for me it was Mirt and venalfaxine:weep:. I suppose I am looking for Holy Grail of somewhere in the middle. That I can feel some energy for life and returned confidence, but at the same time not turn to jelly when the s... hits the fan. bit of a tall order maybe
Cheers
George
Spoke to my Psy yesterday and she has agreed to put up to 75mg twice a day for 4 weeks she was reluctant to even do that. I cant understand since a lot of folk are on 150 twice a day, there seems to be no continuity among consultants, and it was like I really had to convince her to make some increase.
I tried to explain that I will being going back to a stressful job in two weeks after a year and don't want to be battling with side effects of upping the dose when I return. This bears out as I needed to sleep this afternoon after taking my first 75 in the late AM. I had a meeting with my boss at home this morning and the old palpitations started when she described all the changes that has gone on since I have been off. I wanted to go to the bog and throw when she left, so 75 are not cutting it. I am hoping that after the drunky effect of my first daytime 75 wears off so I will get some calm time without the space cadet. I also felt low and a bit depressed after the daytime amount, is this normal (but now feel ok at 8.30pm). I have read in some research that only the larger doses make a significant difference to GAD compared to placebo in the 250 to 600 range and 150mg did not improve symptoms very much . Short of pleading like an addict I am not sure how I can get to the higher dose sooner, which I also told has a stimulating effect on being more social (600mg) which I really need to be in my job. perhaps I just need to be patient
Those results are averaged out over a group, so when a study says its effective at (say) 150 mg per day, it means the mean anxiety score for all participants on 150 mg showed a better result than the mean anxiety score for those taking placebo (and that difference passed a statistical check). However, some of the people in the study may have responded at much lower amounts, whereas others may not have responded at any amount.
What those results mean is that if it is going to work at all, it should do so somewhere between 150 - 400 mg per day for most people (but some people may need less and others more - and for others it has no effect).
Hi Hanshan
Thanks for your reply, was never great with stats, despite having a Psy degree
I must have interpreted it wrong, I just thought that the higher dose showed a more significant reduction in self anxiety ratings than the lower dose. I guess I will have to be patient, probably just as well as I took my first 150Mg in two lots yesterday and could have easily got an extras part in Dawn of the Dead :wacko:. Mornings are by far the worst, suddenly I am depressed all over again, not been depressed for months and don't like this new feeling, definitely hope it goes away in the coming week or so as I need to get back to work, before being threatened with dismissal.
Cheers
Hang in there Funkyman:flowers:
Legally you cannot be dismissed whilst on sick leave. It's difficult but try not to worry about work. And maybe, just maybe you may not be ready to go back if work was the cause in the first place.
Take care Sarah
Hi Sarah
Thanks for the kind reply:hugs:
I work for the council and I am near to a stage 3 meeting after about a year off, this is due at the end of Aug and I have been told that if I don't return in that time they can dismiss on the grounds of capability due to an illness. This is the councils policy. I would have the right to appeal, but don't think it will get me very far. If I am honest its purely for financial reasons me going back as the job is not what I trained to do, and I know longer like it. But with this illness I punish myself about being 'lucky' I have a job in this climate and what hoops you have to jump through to get another. I am old fashioned and feel less of a man when I am at home and not working. I get embarrassed even talking to people and tell them I am on leave if they see me away from work. I was hoping the tablets would make me less susceptible to worry about failure when going back. I did try to go back for a month last Aug but broke down again and felt stupid I had to stop work again. I was also hoping they would take the edge of being anxious about what others think of me at work. I had enough of the Psychodynamic guy today and have decided to look for something different. Cant get on with that Freud malarkey.
My psy doc feels I might have personality disorder traits, that have manifested themselves in being paranoid and finding social situations difficult. Cant believe I am saying this when I was a party animal in my 20's. Anyway pregab......... here's hoping.
:D
Hang in there Funkyman:flowers:
Legally you cannot be dismissed whilst on sick leave. It's difficult but try not to worry about work. And maybe, just maybe you may not be ready to go back if work was the cause in the first place.
Take care Sarah
Sarah
It's a bit of a grey area. If they consider the illness to be a disability, then it's tricky to dismiss you.
I work in Central Govt. and when I was off sick for 2 months our Occ. Health advisor told me over the phone when I said I didn't know when I'd be back: "they could sack you, you know". Not helpful. Not a good "bedside manner". I complained to his company BTW :)
Here's an excerpt from the Government's main site Gov.uk
Illness
You can be dismissed if you have a persistent or long-term illness that makes it impossible for you to do your job.
Before taking any action, your employer should:
- look for ways to support you - eg considering whether the job itself is making you sick and needs changing
- give you reasonable time to recover from your illnessIf you have a disability (which may include long-term illness), your employer has a legal duty to support disability in the workplace (https://www.gov.uk/rights-disabled-person/employment).
Dismissal because of a disability may be unlawful discrimination.
Funkyman
I don't wish to worry you unduly funkyman, because my employer does accept my GAD as a disability, and therefore they have to take all action they reasonably can to help you return and stay at work before considering dismissal.
I hope the drugs work for you - they got me back to work after 2 months off (though they "pooped out" on me after 4 months, which is why I'm on another drug now).
All the best, hope everything works out for you.
Hi Funkyman,
I think you are correct in saying that the higher dose showed a more significant reduction in self anxiety ratings than the lower dose. It's just that these are findings averaged out over the number of people participating in the study (which may be quite small). They should be taken as an indication of the value of the medication and the approximate dosage. However, individual responses may vary.
Nevertheless, in the absence of strong side effects, it's worth giving pregabalin a try up to 400 mg a day for a few weeks. That's no guarantee that the increased dose will work, however.
Hi All
Had insomnia with the 75 last night for the first and felt shocking when I eventually got up. Took the other 75 at 10.00 and been in a bad mood all pm, keep forgetting things and getting frustrated with this semi / hangover drunk feeling. I am 4-5 days in and 3 days at 150mg. Really hope I start to feel a bit like me soon, before it starts getting me down too much, cant afford to be:wacko:, when I return to work a week Tuesday, otherwise I will have to come off them and rely on my own dodgy chemicals.:scared15:
Hayho
If you're only 4-5 days in and less at 150 mg, and already thinking about giving it up, then you really need to step back and relax a bit. It's too soon to make a judgement. What would you say to a teenager who wanted to drop out of education because they got one bad mark on an assignment?
Pregabalin does make a quick improvement for some people - I would guess about 10%. For the rest, if it is going to work at all, it can take up to four weeks at maximum dose. For some people, it doesn't work at all.
In the meantime, there are side effects. What this means is that you should endure the side effects for a month or so - until the beginning of August 2013 if you go to maximum dose from now. By that time, if pregabalin is working, you should have started to notice improvements, plus the side effects should be starting to diminish.
If you're noticing improvements at that time, then go from there. If not, you can ditch it.
You're right,:winks: I just wish I had more time before having to work again as even minor housework is pain in the a...., with this perm hangover. Wouldn't mind but its without one drop of the good stuff!!:wacko:
Cheers
Hopefully, the hangover will start to lift around the start of August (three weeks to wait), and positive effects from pregabalin will be noticeable.
I could not have said it better myself Hanshan:D
Dont give up yet. I felt very strange on that dose but the side effects diminish and become far more tolerable.
Sarah
Thanks Guys, a bit better tonight.
:hugs:
Andrea2607
06-07-13, 21:20
Hi Funkyman,
I take 150mgs Pregabalin twice a day together with 300mg of Venlafaxine and 20mg of Olanzapine at night. I have found this combination works for me and I have not experienced any of the drunk and groggy feelings. I helps with my racing thoughts and anxiety generally. Just going outside is a mission although I am managing to hold down a 30hr telesales job which I only started a week ago. Good luck with the Pregabalin there are some good comments on here about it check them out.
Andrea x
Hi Andrea
I am really happy for you, that you have found a good drug combination and many congratulations on your work situation:D. After a year of about 7 different anti dep and more recently Lamictal / Lamortragine I have started to get jaded about them and if I would be able to get on with any of them. The latest with pregab is a pounding head late at night and early AM, wore off after an hours. I left the tap on in the kitchen while trying to do a barbecue yesterday, woops next thing floor flooded. Men really cant do 2 things at once, especially if on Pregab:huh:
If I am honest I get a bit jealous of people who write comments like 'its changed my life after a week I feel great' etc, while I walk round in an angry half drunk stupor:wacko:.
Still I will not give in:winks:.
Kind Regards:flowers:
I'd have to say that the people who say pregabalin has changed their life in the first week are probably the lucky ten per cent.
For the the other ninety per cent, maybe half will get some benefit and half won't. This is just my guess based on what I've read from studies and posts to NMP - I don't think anyone really knows.
My feeling is that you have to commit to at least one month at a therapeutic dose (150 - 400 mg per day) before making a decision (unless side effects are intolerable).
Hi Hanshan
Thanks for the voice of reason. I will try not to moan... too much:winks:
Regards
Hi all
The daytime sleepiness has started to diminish, which is good:).
But I have had issues with getting to sleep. Take my 75mg at about 10 and bed for 11/11.30. have started to exercise more to get my body knackered. Could be the anxiety of starting back to work:scared15:. Also waking up at about 5.00 and then feeling very tired up to 12.00am.
Anxiety has lowered in a mild and general way, but anything significant ie falling out with the bank and the old stomach churning returns. Thoughts are not as constant in terms of racing as much as before, but again anything to disrupt this relative calm, still has the potential to cut through as before, this was not so much the case with a benzo. But then again with them I was not in tune with normality as much (if there is such a thing). I wonder if after a week I might be able to increase slightly. Also not feeling as much depression / anger, perhaps as I am not putting a new
pint of milk in the bin and flooding the kitchen.:doh: (still shi...ing myself about going back to work and being a failure, also paranoid of their opinion about me) lol
Love all:hugs:
Funkyman,
Good to hear you are feeling a bit better. Remember the side effects do lessen with time.
The THOUGHT of going back to work is bound to make you anxious. I know it's difficult but try to relax a bit more ( some breathing exercises might be good).
Take care
Sarah
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