pregabalin while in valium withdrawal

[kindred1666]

hi guys...Am new here and have a question that is constantly in my head at the min....i have been free of valium for 4 months (just coming up this week) after going CT. My gp gave me pregabalin 8 weeks ago at 25mg x 3 daily and it has def helped my anxiety but i am worried that being on pregabalin is in some way going to prolong or even prevent me from healing from the benzos? (i was only on the valium for 4 weeks at 6mg a day) any encouraging words would be great at the min as this doubt is plaguing my mind at the min...many thanks

[SmilingAlbert]

Hi Kindred,

I have never taken Valium etc for any length of time. However, there is I think some evidence that Preg can help Valium etc. users wean off it. There is also a body of evidence that going to Preg can be very helpful as Preg is much more medically appropriate long-term since it doesn't seem to have the tolerance etc. issues as Valium etc.

Basically - all the evidence is that you need to increase the dose of Valium to get the desired effect the longer you stay on it. Studies suggest that this is not - generally - the case for Preg. Thus most doctors have no problems with long-term Preg prescription, while they will not - in the UK at least - prescribe benzos like Valium for any length of time unless there are special reasons. My personal conclusion is that specialist psy-docs are OK with Preg, but not benzos.

It sounds like you are making progress, and if you have been off Valium for 4 months then I think "you are off it". Preg is not a benzo and works completely differently from a chem point of view, though its effect is said to be not dissimilar in some respects. One day at a time - being off benzos is a great first step.

Albert

[kindred1666]

Thanks Albert

thats very reassuring as i have been constantly worried about being on the pregabalin as i have heard conflicting stories about it preventing "benzo healing" .. I was given bad advise by my gp and was told to "cold turkey" the valium as it was safe due to very short term use and a low dose...i did as he said and have been in hell ... I had seizures on and off for the first few weeks of coming off the valium but all the consultants i saw said "it could not be valium withdrawal and put it down to "anxiety" ! which is why my gp prescribed pregabalin..i am only on a low dose at the min 25 mg 3 x daily .. but if its safe to be on it while still in benzo withdrawal then i will stay on it for a while because it has really helped the withdrawal anxiety....thanks albert for taking the time to reply..if anybody else has any input also that would be good to xx

[MyNameIsTerry]

With Diazepam it has a very long half life in terms of the active metabolite. But to determine if you were Benzo free before you even started the Preg you could use the standard pharmacokinetic calculation for drug elimination which is 5x half life for <5% (clinically insignificant) and 7x half life for complete elimination. This is based on the last dose you took and it at 7x half life:

Active drug
48 hours (Half life) x 7 = 336 hours / 24 hours (to get it into days) = 14 days.

Active metabolite
100 hours (Half life) x 7 = 700 hours / 24 hours (to get it into days) = 29.2 days.

The standard calc isn't accurate but it's a guide. So, you could have been out of the elimination looking at that.

One final factor is that Diazepam builds up outside of blood plasma too and this may take a little longer to eliminate but with you only being on for 4 weeks at a low dose, it may not amount to much when you consider higher dosage users on them for years. This is why people can get picked up on drugs tests for this med months after being off them, this and the long half live of the active metabolite.

[kindred1666]

thanks for the reply terry...What i have been worried about is the pregabalin will somehow prolong or prevent the brain and cns healing due to pregabalin working on GABA in the brain also (like the diazepam did) but i'm not sure if it works on the same brain receptors as benzos do though...any thoughts on this ?

[MyNameIsTerry]

That's a tricky one that I won't pretend I understand. I would have to read up on that.

What I can briefly is that Benzo's bind to the GABAA receptor whereas Preg does not. The Benzo increases chloride ion influx. Preg does not bind to Benzo receptors or GABAA or GABAB receptors. Preg is a calcium channel modifier.

That seems to suggest different pharmacodynamics but without a bit more reading, I don't know about any crossovers since these affect more than just GABA for a start.

[kindred1666]

Thanks for your reply terry

[hanshan]

Despite the name, pregabalin does not have any effect on GABA receptors (post-synapse), as do benzodiazepines. It was initially synthesized as a GABA precursor (hence the name), but found not to act as such.

Intriguingly, its effects on anxiety were nevertheless somewhat similar to benzodiazepines. It was later found to act on the calcium channels (pre-synapse) that are related to the release of neurotransmitters which can cause neuropathic nerve pain, seizures and anxiety (hence its varied use).

(The synapse is the gap between nerve fibres, which is crossed by neurotransmitters that are released pre-synaptically and taken up post-synaptically).

[kindred1666]

Thanks hanshan..So you think i will heel just fine from benzo withdrawal while still being on pregabalin ?...(or would being on pregab whilst still being in benzo withdrawal prolong or prevent healing ?)..I seem to be constantly asking myself that question at the min and its worrying me...thanks for your help hanshan

[hanshan]

Hi Kindred,

I think the fact that you took a benzodiazepine for just four weeks would mean that you would only need several days to a week to physically withdraw.

If you had physical symptoms past that, I would have to agree with those doctors who said they were psychological in origin.

I do think that you are long since withdrawn from diazepam, so pregabalin can have no further effect on this.

Worrying continually about issues such as this is a form of health anxiety, where people continually fear and seek reassurance about a medical condition. Unfortunately, the reassurance is short-lived and the anxiety ever-recurrent.