Panic Attacks Caused by Pregabalin?

[oracle133]

Hi,

I was prescribed 100mg pregablin/day for neuropathic pain, I have a lower back injury. I do not have any history of anxiety or depression. I've been taking my dosage for about two weeks and have had two intense panic attacks during this period (usually within 1 to 2 hours after taking my 50mg pregabalin pill) and have generally felt quite anxious - I've not been able to sleep properly due to adrenaline rushes and feeling that my heart is beating too strongly, and have had to take sleeping pills to get any sleep.

I know that pregabalin is prescribed to treat anxiety, but has anyone else had a similar experience to mine? While it does help moderately with my neuropathic pain, these side effects are far too much of a disadvantage for me to keep taking it I think. It is much harder to function day to day with this anxiety than with the chronic pain at the previous level. On the other hand if other people have been through this and think that within another week the side effects could die down, maybe it is worth sticking it out.

[SarahH]

Very strange! Personally it stopped my panic attacks. Perhaps you could leave it for another week and see if the side effects go. If it is helping the pain then its worth giving it a little more time.

Sarah

[MyNameIsTerry]

I can't speak for this medication but I'm on Duloxetine for my anxiety and the dosing is the same as my current dose protocol (start on 30mg then move to 60mg). My medication caused me some increased anxiety on the starting dose but moving to the standard dose did cause me some serious problems with greatly increased adrenaline.

Whilst these may work a different way, and I think you need the guys on her who user it for that part, I just wanted to reassure you that it can happen on other medications used for your purpose. I don't know if Duloxetine only causes it in current anxiety sufferers although it does not say this in the PIL so I assumed it was a possibility to all users.

[SarahH]

The thing is Pregabalin is an anti-anxiety drug and specifically for anxiety. It does not work like other drugs. I'm nit good at explaining the "how" it works stuff. Hopefully others will add to this thread and explain better than me.

Sarah

[MyNameIsTerry]

Thanks Sarah,

I have no idea about Pregabalin, I just know Duloxetine is prescribed in the same way although it will likely have a different method of action. My dad had some neck pain and his GP lobbed a small dose of medication at him (no exercises, no advice, nothing!) and when he got it home it was clearly an antidepressant so he decided he would rather have some neck pain than end up in the side effects trap with us lot!

I'm guessing perhaps hanshan will be able to help here as he seems to have done a fair bit of research on it all.

[SarahH]

I'm sure he will help with this one.
I can't remember anyone else on this forum saying it was triggering panic attacks..but I may be wrong:shrug:

[MyNameIsTerry]

Well, if it was like my Duloxetine experience I think it would put the substance misusers off! :winks::D

[hanshan]

All of of these medications can have what are called 'paradoxical' effects, where they produce results the reverse of what most people experience.

For example, benzodiazepines (eg diazepam) can make some people hyper-manic, when for most people they have a calming effect.

In fact, although the difference from the desired effect may not be so pronounced in any particular case, there is always a difference according to whoever takes the medication.

If you get a strong, continued, paradoxical reaction from any medication, you should stop taking it. However, paradoxical reactions are the exception rather than the rule.

Also, there is also the possibility of start-up anxiety, where a person suffers anxiety-related symptoms due to starting a new medication. (I want to call this "medication anxiety", but Google only gives me medications for anxiety).

[MyNameIsTerry]

That makes sense hanshan, we have Zopiclone threads on here that state they have had heightened anxiety.

I remember taking 2mg Diazepam was fine in my first breakdown for about a week and then it either did nothing or made me feel more anxious.

According to Drugs.com, anxiety is listed as a side effect in the less common sub category of side effects that may not need medical attention (the ones where they say they will pass as the side effect window ends for the OP's benefit). I know in SSRI/SNRI's they usually tend to say that they may heighten existing anxiety but I didn't see this mentioned with Pregabalin which is good news for people who have passed through various meds as the last thing they want it more of that!

[oracle133]

Thanks for all your replies.

It's true that it probably isn't possible to determine whether the panic attacks are being caused 'purely' by the pregabalin or whether I'm just particularly anxious due to taking medication and that's leading to panic attacks, or whether there's a combination of both.

What I have noticed is that the last two panic attacks have occurred roughly 2 or 3 hours after taking a 50mg dose, and that usually for around 5 or 6 hours after I've taken a dose I generally experience heightened anxiety. I have dropped it down to 1 50mg tablet per day now (rather than 2), and so far I seem to a lot less anxious...

But who knows. Maybe these reactions will pass. The problem for me is that while the neuropathic pain I have is debilitating, and the pregabalin does help it, having these panic attacks, not being able to sleep properly, and the general anxiety I've had over the past week have been more debilitating, and so I'm not sure if it's worth the risk to continue taking the drug. It's sort of exposed to me how fragile my prior, stable mental state was, i.e. just by taking this drug for a small period of time my quality of life can change hugely for the worse...so I'm just wondering if it's worth risking my mental health for moderate but less significant benefit to my chronic pain.

I'm going to keep taking 50mg per day for the next week and monitor what happens.

[SarahH]

Good plan:)

[MyNameIsTerry]

I think the other members need to comment on the side effects window for this medication but I can say that they also use my med, Duloxetine, for neuropathic pain on the same basic dosage and that can either heighten current anxiety or create anxiety in someone who has no mental health issues. This passes once the side effect window is over. This is often considered about 4 weeks but mine at full dose was 8-10 days.

So, perhaps it will be the same for you and that your prior mental system was fine, I'm sure hanshan will throw some light on this. I think you would know yourself if you were anxious beforehand so think back first.

[Dazza123]

I have just started up on them for the 3rd time, and I am getting anxious about 6 hours after taking my morning one, but I have obviously had this in the past, and it does pass after a short while.

[hanshan]

I wish I knew for sure the reason for paradoxical reactions.

One suggestion is that the body responds to a drug with a rebound effect that is actually stronger than the original drug. In effect, the body is trying to go back to the old status quo, but overshoots the mark. This may settle in a couple of days.

Another possible cause is that a calming effect in one part of the neurotransmission process may allow the release of excitatory neurotransmitters further down the line.

However, this is all just speculation - there is still much to be learnt about neurotransmission and neural pathways in the brain.

Nevertheless, the mere fact that we can talk about different neurotransmitters in the brain represents a vast advance on just a few years ago.

[SarahH]

Wouldn't it be great if we could just "re-boot" our brains like a computer so the neurotransmitters go back to the beginning:D

[hanshan]

The best thing I like on computers is "system restore", where you can go back to how your computer was a few days ago if you are having a problem now. I discovered it back in the Windows 98 days, when you had to hold down the Control button while the computer was booting up, then enter "scanreg restore" or something similar.

But for most of us, problems come from a combination of genetics and upbringing - all long ago and far away now. We can't go back to a point when everything was fine.

Nevertheless, every day is a new day for the brain. I believe that it does have the capacity to create new and good things, even if the present state may not be the greatest.

[SarahH]

:DNeuroplasticity...we CAN retrain out brains....hoorah!

[Hipha]

Hello Oracle133

Hope that you are well?

I am interested to know how you are now with pregabalin? Did you continue or stop pregabalin?

I started pregabalin recently and had my first panic attack last night. I like hanshans explanation about a possible rebound effect which makes logical sense to me as we all see heightened symptoms when starting and stopping use of drugs.

[cristine]

I have just started up on them for the 3rd time, and I am getting anxious about 6 hours after taking my morning one, but I have obviously had this in the past, and it does pass after a short while.

Hi:) I find the anxiety heightened at apx 2-3 hrs after taking dose but it's like a wave which peaks and crashes then the calm is there -could be just me? :D
x

[Sober2000june]

Not just you Christine, I get it early evening after my afternoon dose.
Paul

[cristine]

Hi paul- nice to know I'm not alone :D

[Hipha]

I am also now experiencing more anxiety on Pregablin. As described it comes on after taking my morning dose and lasts for 3-4 hours then subsides. Has anybody pushed through this feeling and found Pregablin eventually relieves anxiety instead of increasing it? I am also feeling panic feelings which I have not felt before taking Pregablin. In the future we will know how and why the brain functions in the way it does and why different reactions occur across different people. Hopefully this will happen in our life time.

[imsimsj]

I know this is an old log but I wanted to share with you that I had taken lyrica for about a year and suddenly got Panic Disorder. It has been really bad the last two years. I stopped taking the Lyrica two years ago but the symptoms are still with me. I never in my life had anything close to a panic attack. I was very athletic and I can no longer workout without paying the price of a panic attack after it's over. There is no doubt in my mind that Lyrica caused the Panic Disorder. I warn people about taking this medication or any of the antidepressants they try and treat my condition with have some horrible side effects. If I could go back I would just deal with the nerve pain and not have taken anything. It has ruined the way I used to be. Best of luck with everything and I hope you haven't developed a permanent condition due to Lyrica.

[hanshan]

Hi Imsimsj - If you discontinued pregabalin but are still getting panic attacks two years after discontinuing, it's very possible that the panic attacks have their own causation. Pregabalin is approved in the EU and UK for generalised anxiety - it's not really strong enough to prevent a full-on panic attack, so it may not have been able to stop your first panic attack. Panic attacks can start at any age, even among people who have been mentally resilient through all life's shocks to that point.

[RandomGeeza]

I'm going to jump here too. And like above, I appreciate it is an old thread.

However, I have been experiencing post Pregab dose anxiety also. Even on a single does of 75mg, within 6 hours I start to experience depersonalisation, which then leads to a sense of panic or anxiety. Needless to say I have stopped the medication and I am going to report back to my GP to see if there are any alternatives.

Having suffered with anxiety since a major op two years ago. And then recovering from that anxiety. To suddenly find my mental state as fragile as the Pregab side effects are implicating. I am troubled to say the least. Even though I realise that it most probably is the Pregab, given it is the only new thing introduced in to my daily regimen.

[Hipha]

I was prescribed lyrica for anxiety which appeared after being prescribed antidepressants. Lyrica / pregabalin is prescribed to ease anxiety but its effectiveness is not proven and in fact there are many experiences posted on the web where it has caused anxiety where it did not originally exist. As to it causing panic attacks then there are some instances of this happening although most describe as bad anxiety. There is no doubt that it can cause anxiety especially after stopping its use abruptly. I needed 7 months to wean myself of it and if I dropped more than 2mg per fortnight I experienced awful flu like symptoms for 2 days. Awful drug but now that I am off it I do not experience any long term effects.

[hanshan]

The effectiveness of every new drug released today has to be demonstrated in the Phase 3 trials (involving a number of studies in different locations prior to release, with two or three thousand people taking the drug). This is also true for pregabalin, where several studies showed it was effective for generalised anxiety for many people.

However, unfortunately, there are always a percentage of people who do not tolerate any particular drug, and must discontinue due to side effects - in this case, some people find it makes them feel more anxious, not less. This can particularly be the case for people with anxiety, who already are anxious about taking a new medication.

To minimise start-up side effects, many doctors start with a very low dose and gradually build up - this may also be useful for pregabalin. But if intolerable side-effects occur, then discontinuing may be the only option. I always say "good luck" with pregabalin because although it's been very good for a number of people, unfortunately it's not 100% guaranteed.