Pregabalin taper schedule

[akb]

Hello

I'm on 200 mg of pregabalin about 6 months now. I'm not convinced its helping me so want to come off it, its also expensive and my supply unreliable. Any help would be gratefully received. I don't have a doctor.

akb

[akb]

Looks like I'll have to answer my own question again.

I'll start by reducing by one 25mh capsule for one month at a time and see how it goes

[skymaid]

The actual Lyrica (Pregabalin) official prescribing info says:

"Your healthcare provider may change your dose. Do not change your dose without talking to your healthcare provider.
Do not stop taking LYRICA without talking to your healthcare provider. If you stop taking LYRICA suddenly you may have headaches, nausea, diarrhea, trouble sleeping, increased sweating, or you may feel anxious. If you have epilepsy and you stop taking LYRICA suddenly, you may have seizures more often. Talk with your healthcare provider about how to stop LYRICA slowly. "

and

"Taper LYRICA gradually over a minimum of 1 week rather than discontinuing the drug abruptly."

But you don't have a doctor so that doesn't help much - 25mg is the smallest capsule so I guess short of going to a doctor you can just try reducing it by that and see how it goes.

I've missed the odd one or 2 doses now and again and not really notice anything nasty (slight headache).

I wouldn't do too much internet "research" or you'll upon horror stories which will just scare you into psychosomatic symptoms anyway.

The internet is great for many things but medical advice from the general public isn't one of them.

My doctor says I might feel a bit "ugh" when i stop them but nothing too serious.

Can you not go to a doctor?

[akb]

Hi sky maid

Believe it or not I'm in a foreign jail which doesn't have a doctor
Lyrica seems to be unknown here.

Thanks for your reply
I am in no hurry to reduce anyway

akb

[hanshan]

I would reduce your daily dose by one quarter (50 mg) and see how you go. If problems arise on a particular day, you can always take the extra 50 mg.

Once you are stabilized on 150 mg daily, you can drop another 50 or 25 mg, and so on.

[akb]

Hi Hanshan

I was actually waiting for you to offer your expert advice. I will do as you say and report back in due course.

Just out of interest, is there a recommended minimum dosage for anxiety, or does it all depend on the person?

Thanks

akb

[beatroon]

I tapered off it and managed to go down in 25mg increments, but towards the end I found it a bit rapid, and ended up taking some of the powder out of the capsules. It was unscientific and probably not great but it did help. By the end I was literally just tapping a bit of powder back into the capsule and having that. Good luck. It can be done.

[akb]

Thanks beetroon

I'm in no hurry so I will be able to do it

akb

[akb]

This may be a silly question but how many days after reducing dosage can you be sure its been successful? Given that you may be feeling a little anxious about reducing in the first place.

Having gone cold turkey on benzos I know that withdrawal symptoms start around day 3 or 4 but obviously this is not the same

[hanshan]

Withdrawal rate from any psychoactive med depends a lot on the person. Some people can taper down to nothing in a few days with few effects while others need weeks or months.

Although pregabalin has a short elimination half-life of around six hours, there are still issues of the body stabilising at the new dose. As a rough guide, if a week has gone by at the new dose and you have been fine for the past three days, then you are probably okay at the new dose.

From that, there is no urgency for a further reduction straight away. It's a case of when you feel ready. As pointed out above by Beatroon, as you get towards the end, even small reductions become a large proportion of your dose.

[akb]

Hi Hanshan

Thanks again for replying

5 days have gone by and I feel no different so I guess its gone well

akb

[akb]

I checked some old threads to answer an earlier question regarding dosage and came up with this from Hanshan

The dose varies considerably according to the person taking it, but a rough guide is:
0 - 200 mg per day - low dose
200 - 400 mg per day - mid dose
400 - 600 mg per day - upper dose

Nella131 a student nurse added that she had been told by her psych that anything below 150 was unlikely to have any effect

I am stable on 150 and will remain on it a while

akb

[hanshan]

Hi Akb,

That's a very rough (but still useful) guide. The range of 200 - 400 mg per day is based on clinical trials which show a statistically verifiable improvement over placebo at that dose (actually, I think closer to 400 mg per day). Nevertheless, individuals may respond at doses both below and above that range. Various people have posted to NMP taking doses less than 200 mg per day which they are happy with.

Another factor is whether pregabalin is combined with another psychoactive med, and how the two combine.

Overall, some informed trialling of different levels is not amiss, given that most people seem to want to find the minimum effective dose.

[akb]

Hi Hanshan

You may be able to answer this query.

I cut down from 200 to 150 over 3 weeks ago. The other day the UK embassy came to visit, something triggered a huge spike in my anxiety level and am still struggling now.

Could this have anything to do with reducing the Lyrica? As I said earlier, I have never been convinced it was helping much anyway and a bigger dose was out of the question for various reasons.

Thanks for reading

akb

[hanshan]

Hi Akb,

Sorry to hear about the spike in anxiety. Pragabalin / Lyrica works best for persistent levels of low to medium anxiety - mostly generalised anxiety GAD. It's not 100% perfect for preventing a panic attack or a neutralising a particular event that might make you very anxious, though it probably helps.

Also, if you are on a downward taper, you are also particularly vulnerable. If possible, keep some in reserve so that you can temporarily go back up a step if necessary at a difficult time.

Best of luck in your present circumstances - I don't know I how I would cope at all, so you are doing well.

[akb]

Hi Hanshan

I increased it back up to 200 and am feeling a little better. Would you concur with me that it was having s positive effect after all? I only decreased because I thought it wasn't.

akb

[hanshan]

Hi Akb,

Pregabalin's effects can be subtle - I often say that it's working best when you don't feel anything except that you are not as anxious as before. So pregabalin may have been having a positive effect that you didn't notice. Also, it's not so good for anxiety surges related to stressful situations, and I'm guessing that applies to you. However, it may help a bit, if not completely. My best wishes to you.

[akb]

Hi Hanshan

Thanks again for your helpful comments

akb