Up and Down...why?

[Utah49er]

So I started taking Pregabalin about a week ago. Started at 75mgs/twice a day. I quickly noticed a pretty good anti/anxiety feeling about two hours after the 1st dose. After a couple of days, I noticed my anxiety comes back HARD about 4-6 hours after a dose, so I was told to take 75mgs 3 times a day. I did that for about 4 days and loved the few hours of relief it gave me, but the anxiety still hit hard before it was time to dose again. My doc just upped me to 150mgs/3 times a day, and this has seemed to really help the effects last longer...but not quite to the next dose. I am sleeping great for the 1st time in 4 months, and when the Lyrica effects hit, it is really a nice break from the anxiety, though I am a bit spaced out (maybe kind of high?). Just wondering, will this level out to a more consistant effect on my anxiety? Do I need to dose 4 times a day? (Really expensive to do it this way, not sure if insurance will cover it)? The pregabalin obviously has a positive effect on my anxiety, but the up and down roller coaster is pretty frustrating. Anybody experience this, or can offer some advice?

[panic_down_under]

Do I need to dose 4 times a day? (Really expensive to do it this way, not sure if insurance will cover it).

Welcome to No More Panic,

Pregabalin has a short elimination half-life of around 6 hours, however, it can remain effective for a few more hours for some. It appears you may be metabolizing it faster than most.

[Utah49er]

Welcome to No More Panic,

Pregabalin has a short elimination half-life of around 6 hours, however, it can remain effective for a few more hours for some. It appears you may be metabolizing it faster than most.

So will this kind of be my experience with this drug? Is it not likely to level out? I have been really struggling the last 4 months and kinda desperate for something to work. This has been the best so far. Was on Zoloft (50mgs) for 8 years after my first anxiety episode, came off it in October and felt totally fine after about 3 weeks of discontinuation effects. In January had some anxiety creeping back and thought I would be proactive and restart the Zoloft...well it didn't work and made my anxiety crazy high. Tried 6 weeks of Zoloft, didn't kick in, switched to Lexapro for 7 weeks...it never kicked in either. Then started the Pregabalin a week ago and have been very encouraged by the early effects, but the crashes are rough! Hoping this is the answer and I can get back to life.

[panic_down_under]

So will this kind of be my experience with this drug? Is it not likely to level out?

A higher dose may resolve the issue, but there are no guarantees. Pregabalin seems to be one of those meds which work very well for some, but doesn't do much for most.

Was on Zoloft (50mgs) for 8 years after my first anxiety episode, came off it in October and felt totally fine after about 3 weeks of discontinuation effects. In January had some anxiety creeping back and thought I would be proactive and restart the Zoloft...well it didn't work and made my anxiety crazy high. Tried 6 weeks of Zoloft, didn't kick in,

Six weeks if not really long enough to draw any conclusions as antidepressants typically kick-in between 3 to 12 weeks from starting a therapeutic dose. Also 50mg is generally the minimum effective dose with most needing to take 100-150mg for good results and and higher doses are often needed the second time around. The initial side-effects can be more severe and/or different too.

[Utah49er]

Ok, seems like from reviews I have seen (8.1 for anxiety at drugs.com) and looking at websites, including this one, I have heard this has been one that works for a lot of people. Psych doc really thought this would be a good one to stabilize me. I am hopeful the fact that I can feel it working with every dose, that would be a good thing and it would stabilize. Are you on this drug panic? Anyone else who has taken this drug have any thoughts or a similar experience?

---------- Post added at 19:40 ---------- Previous post was at 19:37 ----------

Six weeks if not really long enough to draw any conclusions as antidepressants typically kick-in between 3 to 12 weeks from starting a therapeutic dose. Also 50mg is generally the minimum effective dose with most needing to take 100-150mg for good results and and higher doses are often needed the second time around. The initial side-effects can be more severe and/or different too.

Hmm, if that is the case, my psych doc wasn't very helpful. No kidding about side effects being more severe, they were almost unbearable. Maybe I should try the Zoloft again with pregabalin as a buffer to help me sleep and help with the increased anxiety of Zoloft.

[hanshan]

I have to take issue with the statement: "doesn't do much for most".

I have posted the link to drugs.com once before, where it clearly does much for most, but here it is again:

https://www.drugs.com/comments/prega...-disorder.html

Evidence?

[Utah49er]

Hanshan, do you have experience with pregabalin? If so, what are your thoughts on the ups and downs, is this common while starting this med?

[hanshan]

I have seven years experience with pregabalin. The ups and downs at first are probably due to the short half-life of around seven hours (though it varies from person to person). However, that's half-life, so some always remains and that can accumulate. Furthermore, some meds get taken up by the body and gradually re-released - this may also be the case for pregabalin. If so, this would help explain evening out over time.

[Cherryade]

It took me about 3 months on 150mgs Pregabalin before I felt really better. There is unfortunately no quick fixes. I did have some horrible side effects for the first 3 weeks but these gradually disappeared.

[Utah49er]

I am doing much better now, certainly not back to myself, but better. Currently on 600mgs of Pregabalin, Doctor has prescribed Paxil (Seroxat) to add with the Pregabalin. What are everyone's thoughts? Is this a good combo? The idea would be to use the Pregabalin to help with horrendous SSRI startup effects I have experienced in my recent trials with Zoloft and Lexapro (I didn't get these effects 9 years ago when I first started Zoloft). Then once stable on the Paxil, I would start to wean off the Pregabalin as it is terribly expensive (only wean if possible, I have no problem being on both long-term if I can get back to being myself). Anyone tried this combo or one like it? Any advice or pearls of wisdom before I start the Paxil and take the plunge?