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Thread: advice about pregabalin please

  1. #1

    advice about pregabalin please

    hi everyone,

    i'm male, 44 years old, long term sufferer of anxiety and depression which got worse for me as i got older.

    i'm currently taking venlafaxine extended release 150mg, which i take each morning. a month ago my doc recommended i add pregabalin, i started on 25mg (which seemed like it didn't do anything at all), so i increased over a week or two and ended up now taking 300mg which i take at night before bed.

    i notice that pregabalin at 300mg seems to stop the morning anxiety i had going on for a long time, and although i tend to dream a lot at night, pregabalin seems to help stop the dreams being 'anxiety related' dreams.

    however, when i wake up i do feel quite groggy, and tired - not refreshed, and feeling like i could sleep more (i avoid doing that though and get up). i have been on 300mg of pregabalin for a couple of weeks now.

    so my question is, i'm thinking of splitting my pregabalin dose, perhaps 150mg at night and then 150mg when i get up. that might be a pain to do though as i have the single 300mg capsules. i do feel some anxiety in the daytime sometimes so thought maybe i should try to have pregabalin in my system both at night and also the day. i dont think i want to take 300mg of pregabalin at night and then 300mg in the day also, as that seems like it may be too much for me (i think it could make me too tired and sleepy).

    have any of you had success with splitting your dose? and also do any of you get side effects such as feeling tired etc? perhaps these side effects passed with time?

    i also get quite a dry mouth, perhaps the venlafaxine is causing that, or perhaps pregabalin, or both!

    another thing is i find i tend to wake up a few times each night, rather than sleep right through. i guess that's probably difficult to narrow down though, eg. that could be depression in general causing that, or venlafaxine, or pregabalin.

  2. #2

    Re: advice about pregabalin please

    I would ask your DR to prescribe 150mg to be taken morning and evening. Pregabalin is usually taken twice daily due to the short half life of the drug. The tiredness does ease up over time and you may need a dose increase to maintain the positive effects - 400 to 600mg is usually most effective long term for GAD.

    Tommo x
    __________________
    Diagnosis:
    Borderline Personality Disorder
    General Anxiety Disorder
    Depression
    OCD

    Medication:
    200mg Sertraline
    600mg Pregabalin
    150mg Quatiapine

    Current Therapy:
    Mindfulness
    ACT

  3. #3

    Re: advice about pregabalin please

    Thanks Tommo, perhaps i need to consider that then, currently i get 2 months worth of meds in one go (58 venlafaxine 150mg, and 58 pregabalin 300mg), i pay for my prescriptions so that's around 17 i pay each 2 months. i dont think my doctor would give me 116 pregabalin 150mg in one go unfortunately lol (i think they have rules about giving out too much medication at once, which is fair enough of course). splitting the 300mg pregabalin capsules would have been nice but i suppose if that's a bad idea maybe i will be getting monthly prescriptions instead then and will have to pay more.

    how are you getting on Tommo? i notice you have 'mindfulness' in your signature, do you find that is helpful? also how is your diet? i have cut out a lot in my diet over the months and have found that to be helpful. i recently gave up all fizzy drinks, as i noticed when i was drinking diet coke i was getting restless legs syndrome at night! (something i have suffered with on and off through the years).

  4. #4

    Re: advice about pregabalin please

    I wouldn't recommend splitting the capsules. It's almost impossible to dose accurately and the powder is like talc - it's easy to lose half of it and tastes pretty unpleasant.

    Hopefully the quantity of capsules shouldn't make any difference to your prescribing DR as the overall dose is still the same.

    I have found mindfulness incredibly helpful, probably the only therapy that has made any measurable improvement to my life. I can also incorporate it into my daily routine with very little effort. I did the 8 week group course, attend a guided class once a week and use the headspace app every day. I also found The Happiness Trap by Russ Harris a good read.

    Diet wise, when I am in the grip of anxiety I tend to try lots of different things.... exclusion diets, supplements etc. But when I feel better I tend to abandon it.

    Tommo x
    __________________
    Diagnosis:
    Borderline Personality Disorder
    General Anxiety Disorder
    Depression
    OCD

    Medication:
    200mg Sertraline
    600mg Pregabalin
    150mg Quatiapine

    Current Therapy:
    Mindfulness
    ACT

  5. #5

    Re: advice about pregabalin please

    thanks for the advice,
    i definitely know what you mean about the diet thing, i keep doing the same thing of eating well when i am not feeling good, but then when i feel better i go back to eating all sorts of junk

    i like the look of that happiness trap book, im going to read that for sure

    i tried meditation in the past but it just didn't seem to do anything for me. then i read something about instead some people tending to do better when they do things like hobbies or something with their hands etc. i think i am more that type of person

    can i ask, regarding the mindfulness things you do, does that mean when you are feeling better, you do keep doing it then?
    do you know how long it can take to see results from mindfulness, did you see results in a few weeks or did it take longer? thanks!

  6. #6

    Re: advice about pregabalin please

    I find it even more rewarding doing mindfulness when I am on the up swing and it definately helps keep me stable. I experienced an initial improvement straight away. With medication and daily practice, I have felt a continued steady improvement over a number of weeks.

    Without the medication I still experience relapses though.

    Tommo x
    __________________
    Diagnosis:
    Borderline Personality Disorder
    General Anxiety Disorder
    Depression
    OCD

    Medication:
    200mg Sertraline
    600mg Pregabalin
    150mg Quatiapine

    Current Therapy:
    Mindfulness
    ACT

  7. #7

    Re: advice about pregabalin please

    me also Tommo, i have experimented many times in the past trying to go it without meds but always seem to have to come back to them

    my last attempt at 'no meds', a year or so ago was truly horrendous. i didn't bother with any meds but instead tried diet, exercise, books, meditation, breathing techniques and so on. well, i went without meds for about 8 months, slowly getting worse and worse in my mood, feelings, thoughts, depression, anxiety.. then i crashed so damn hard it was just absolute hell. i was totally struck with severe suicidal thoughts, i don't know how i survived that when i look back. anyway, i got on duloxetine for a month or two but realised although it made me feel better quickly, it wasnt really doing enough to help my anxiety, so i switched to venlafaxine and found that suited me better (although i still felt my anxiety was not quite under control still, so decided to try adding pregabalin).

  8. #8

    Re: advice about pregabalin please

    Hi Sun43

    Up Here i get 2 months supply in one prescription of pregabalin. so 120 x 300mg pills in one go so the NHS do allow it, certainly the scottish NHS. So may be if you ask you will.

    But as I don't pay, nor does anyone up here, maybe that has something to do with it.

    I wish you well, good luck in all you try

  9. #9
    Join Date
    Nov 2010
    Posts
    2,937

    Re: advice about pregabalin please

    Hi Sun43 - I'd definitely consider discussing with your doctor dividing your daily dose into two. That's the recommended dosing regime in all the guidelines, and a box of 56 capsules is usually one month's (four weeks) supply.

    Although it's not recommended, it is possible to cut the end off a capsule with a sharp blade, and then tip the powder out onto a sheet of paper. Use the blade to divide the powder into two halves and transfer one half into some water in a glass. Stir the water a little and drink it down. It doesn't matter if the powder doesn't fully dissolve. Add some more water if necessary. Fold up the paper with the remaining powder and store in a safe place. Not recommended, but I've done it, and it works at a pinch.

  10. #10

    Re: advice about pregabalin please

    thanks for the advice guys,
    hmm im not sure about splitting the 300mg dose as i did sleep quite well last night without waking up through the night, and not over-dreaming/vivid dreams too much, so it seems like 300mg is suiting me quite well taking it all at night before bed.

    i seem to be having something going on for a while now which looks like, possibly 'diurnal mood variation' which really sucks. i can feel like total crap and borderline suicidal in the morning/half of the day, and then come evening i feel better, and quite often as the evening goes on i feel totally normal and 100% fine. then come the next morning it's back to square one.

    im not sure upping the pregabalin dose would help with that, as i imagine it's more a depression thing going on rather than an anxiety thing (but i could be wrong, who knows...)

    i did do a test a few days ago of not bothering taking the pregabalin before bed time but instead took it when i woke up, to see if it helped with that low mood in the mornings/day. it was a disaster, i slept like total crap (must have woke up about 5 times through the night. and i had increased anxiety and depression that day also, which sucked of course).

    i guess i will just have to keep going for now and hope that problem with the mornings/days i have going on perhaps improves with time. maybe i would be better off with mirtazapine and pregabalin rather than currently taking venlafaxine and pregabalin. i did try mirtazapine in the past but got hellish restless legs syndrome (this seems to affect quite a number of people who take mirtazapine, particularly people with a history of having episodes of RLS, such as myself). mind you, now that i am taking pregabalin at night (which seems to be effective at treating RLS in itself), maybe i could get away with taking mirtazapine again.

    anyway will keep at it i guess,
    hope u are all doing well out there

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