Pregabalin - am I meant to feel immediate effects?

[Floods]

Hi guys,

I've been given pregabalin (along with mirtazipine - currently at 45 but reducing to 30 to avoid its massive knock-out effects) for anxiety. My anxiety has slowly been reducing over the last few months, not sure if that's medication or just time but whatever the reason, we're (very!) gradually getting better

Over the last month or so I've been slowly increasing pregabalin my 25mg per week up yo about 300-400; my doctor says the reason I haven't noticed anything positive in particular is probably due to too low a dose (something echoed by a lot of you guys on here). Yesterday I took 600 as recommended and felt a bit unusual, but woke up today absolutely spaced out (something very unpleasant as it mimics the strong depersonalisation/derealisation effects I used to feel so strongly) and this has lasted all day. I have a couple of questions:

1. Is it normal to experience this heavy, spaced out feeling by increasing from 400 to 600? If so, how long would this last? It's pretty debilitating - I couldn't work or concentrate at all today...

2. A lot of people on here talk about immediate effects of pregabalin, even experiencing a "buzz" or a "high". I'm afraid to say I haven't felt his at all, the doctor did say that I should begin to notice effects pretty quickly after increasing my dosage to 600. Does this mean the medication isn't working for me, or is it possible for the anxiety relief to take a good while longer than this?

Thanks guys.

[ricardo]

I was drawn to your post as I take this drug but in low quantities 75/100mg for nerve pain.

from Drugs.com.

Although LYRICA was also studied at 600 mg/day, there is no evidence that this dose confers additional significant benefit and this dose was less well tolerated. In view of the dose-dependent adverse reactions, treatment with doses above 300 mg/day is not recommended

IMO I would speak to your doctor again, maybe the increase is too much.It can't do any harm to discuss this, give him/her a call.

[Floods]

Wait, I'm confused now... conflicting sources suggesting I shouldn't go above 300mg for anxiety, whilst on the other hand it's only ever going to be effective above 400mg? :/

[hanshan]

I think the 300 mg figure was for neuropathic nerve pain, where it is likely that people are taking other medications as well.

Different studies always seem to get different results, and the final results are really an average based on quite varying individual results.

Based on people posting on NMP, some people actually respond at quite low doses, and others not. If 400 mg seems to be having some effect and 600 mg makes you feel spaced out, then somewhere around 400 mg may be the best compromise dose for you. You could also persist a while at 600 mg to see if the side effects subside. It's just trial and error till you find the best dose - good luck with it.

[Hipha]

BE careful floods. 600mg is a very high dose for anxiety although it appears that psychiatrists are quite happy to prescribe this dose. I have had a bad experience with Pregabalin which was prescribed for anxiety and I am wary that my opinion is biased against it for anxiety and pain unless extreme anxiety or pain are suffered. There are many examples on this forum and others of success with pregabalin for anxiety but I am concerned that you are increasing dosage to such a high level and so quickly. My view is that if you do not feel any benefit for anxiety at 400mg after 2 weeks then it is unlikely to help you. This is not a drug you should be staying on if you are not receiving any (or minimal) relief for anxiety. Withdrawal can be nasty and prolonged even where taken for a short time period. Can I ask have you ever forgotten to take a dose of pregabalin? If yes what happened?

[Floods]

BE careful floods. 600mg is a very high dose for anxiety although it appears that psychiatrists are quite happy to prescribe this dose. I have had a bad experience with Pregabalin which was prescribed for anxiety and I am wary that my opinion is biased against it for anxiety and pain unless extreme anxiety or pain are suffered. There are many examples on this forum and others of success with pregabalin for anxiety but I am concerned that you are increasing dosage to such a high level and so quickly. My view is that if you do not feel any benefit for anxiety at 400mg after 2 weeks then it is unlikely to help you. This is not a drug you should be staying on if you are not receiving any (or minimal) relief for anxiety. Withdrawal can be nasty and prolonged even where taken for a short time period. Can I ask have you ever forgotten to take a dose of pregabalin? If yes what happened?

To be fair, I was told to continue at 400 and then increase as best I can upwards up to the max of 600, rather than being told to hike straight up to 600. Having felt nothing in particular over the last week or so on 400, apart from that spaced out feeling, today I took 550mg. It's given be a definite 'buzz', almost as if I was high or tipsy/drunk, and it's sort of pleasant, but the anxiety is still underneath.

So not sure if that's a good sign or not. Whilst this feeling is nice enough, I suppose, I certainly don't have the concentration I normally would, and couldn't cope with feeling this 'high' all day.

I haven't yet missed a dose of pregabalin; sometimes I forget to take it on mornings but I remember at the evenings and haven't noticed anything in particular.

I'll see if anything improves in the next week or so; it's quite hard to tell if there's been any change, but certainly no real noticeable drop, it seems :(