How long before pregabalin starts to work?

[Belfry1973]

Hi chaps

I'm another one on pregabalin, in fact I wrote the rather big diary about it a few posts down!

It took a week to work for me, I did get the euphoria feelings got strongly at first, but they did settle down, came back when I increased the dosage, am currently on 300mg, up for 150 when I started.
Occasionally I do still get the 'whooaahhh' feeling, however what me and JT found was that taking them on a full stomach, particularly in the morning really stopped that happening.
I do drink with them, however I have found that its no so much the alcohol increases the effects of the pregabalin but its the alcohol effects themselves that are increased! I can now only manage about 2 drinks!

Keep at it people, it's definately worth it!

[keval]

Hi Keval,

I'm taking pregabalin 600 mg per day (2 x 300 mg capsule - although I built up to that level over a couple of weeks) for generalised anxiety. It's been a godsend to me. I no longer wake up feeling anxious in the morning, and that constant sense that something awful was going to happen has gone. That's not to say that I don't have concerns and worries, but they're at a normal level, and I can deal with them like most people. For me, it worked quickly, but studies suggest about a week for it to have an effect. You may get benefit from combining it with another medication. I'm also taking mirtazapine 45 mg per day.

Side effects - I felt a bit spacey and uncoordinated for about three weeks, but that has subsided. I get a dry mouth from time to time, but having a water bottle handy fixes that. Apart from that, I feel ordinary. It greatly increases the effects of alcohol for me, so this is an area to take care.

Dosage - It's important to get a dose at a therapeutic level. Research studies suggest that significant improvement starts at around 150 mg per day and keeps improving up to 400 mg per day.

Best wishes,

Hanshan

Hello Hanshan,

Thanks for your detailed reply, which is very informative and useful.

I'm still at 300 mg per day of pregabalin taken as 150mg in the morning (approximately 10:00am) and another 150mg at night (approximately 10:30pm). After precisely 13 days, I have not experienced any improvement in my anxiety. Nor have I had any significant side-effects with the very notable exception of that to which I hinted above. My psychiatrist had originally suggested increasing to 450mg per day after seven days but, being the ultra-cautious person that I am, I decided to hold out a little longer. However, I suspect that I'll take that leap tomorrow and then I'll be on 450mg per day.

I had noticed that several people are/were taking mirtazapine but I'm unclear whether this helps or not. I'll probe through some more posts to get a feel for this.

You make reference to "Research studies suggest that significant improvement starts at around 150 mg per day and keeps improving up to 400 mg per day". I'd be very interested in pursuing this. Can you point me in the direction of any research studies that address this topic?

Once again, thank you.

keval

[keval]

Hi chaps

I'm another one on pregabalin, in fact I wrote the rather big diary about it a few posts down!

It took a week to work for me, I did get the euphoria feelings got strongly at first, but they did settle down, came back when I increased the dosage, am currently on 300mg, up for 150 when I started.
Occasionally I do still get the 'whooaahhh' feeling, however what me and JT found was that taking them on a full stomach, particularly in the morning really stopped that happening.
I do drink with them, however I have found that its no so much the alcohol increases the effects of the pregabalin but its the alcohol effects themselves that are increased! I can now only manage about 2 drinks!

Keep at it people, it's definately worth it!

Hi Belfry,

Thanks for your reply.

I have noticed that several people commented about taking pregabalin on a full stomach. Invariably, mine are taken on an empty stomach (particularly my morning dose) and I am unaware of having taken the medication. Hope this doesn't mean that it's not going to work for me!

keval

[ems43]

Hi keval,

Just to let you know that i read an article the other day by BMJ on anxiety which stated it can take up to 4 weeks to have an effect, so don't be too worried yet. The research articles I have looked at seemt to assess patients anxiety using rating scales at the start and end of the trials, usually minimum 4 weeks, therefore it could be that it take that long for them to have an effect. I am now on day 6, and unlike you have experienced some pretty rough start up effects, feeling very stoned/ drowsy still and increase in panic attacks. I am also on 45mg mirtazipine, which is also sedative, so may be that these are just increasing the effects of the mirt. I am going to stick at it for at least another week, as Bels and others have had really good results. The other day I felt very low, scared that if this wonder drug did not work for me then nothing would! Spoke to my cbt therapist about it the other day who reminded me we all have different reactions to medications- one persons wonder drug is anothers nightmare. So, I guess just give it a shot and remember that if this doesn't work, there are lots of other things that can help. Are you on any other meds?

[hanshan]

Hi Keval,

There's a review article at:

http://www.ncbi.nlm.nih.gov/pmc/arti.../NDT-3-237.pdf

which cites a number of studies, summarized in a table.

Remember: these are studies - you're an individual.

What look like outright effects are actually averages for the group. Individual effects can vary quite a bit. Also, it looks like these groups started out on fairly hefty initial doses.

Do think positive (I know it's hard to do with GAD). It's always been my thinking that eventually something will work.

Best wishes,

Hanshan

[keval]

Hi Keval,

There's a review article at:

http://www.ncbi.nlm.nih.gov/pmc/arti.../NDT-3-237.pdf

which cites a number of studies, summarized in a table.

Remember: these are studies - you're an individual.

What look like outright effects are actually averages for the group. Individual effects can vary quite a bit. Also, it looks like these groups started out on fairly hefty initial doses.

Do think positive (I know it's hard to do with GAD). It's always been my thinking that eventually something will work.

Best wishes,

Hanshan

Hi Hanshan,

Thanks for replying.

Ironically, I am aware of the review article for which you have kindly provided a link. Clearly, I need to re-visit it and study it more closely!

All the best!

keval

[keval]

Hi keval,

Just to let you know that i read an article the other day by BMJ on anxiety which stated it can take up to 4 weeks to have an effect, so don't be too worried yet. The research articles I have looked at seemt to assess patients anxiety using rating scales at the start and end of the trials, usually minimum 4 weeks, therefore it could be that it take that long for them to have an effect. I am now on day 6, and unlike you have experienced some pretty rough start up effects, feeling very stoned/ drowsy still and increase in panic attacks. I am also on 45mg mirtazipine, which is also sedative, so may be that these are just increasing the effects of the mirt. I am going to stick at it for at least another week, as Bels and others have had really good results. The other day I felt very low, scared that if this wonder drug did not work for me then nothing would! Spoke to my cbt therapist about it the other day who reminded me we all have different reactions to medications- one persons wonder drug is anothers nightmare. So, I guess just give it a shot and remember that if this doesn't work, there are lots of other things that can help. Are you on any other meds?

Hi ems43,

Thanks for the information.

I tried to search for BMJ articles online but it seems that one has to pay for them. Perhaps you would be kind enough to provide a link to the article you found about the "up to 4 weeks to have an effect". I guess it's possible that you have access to these articles but are not permitted to link to them. Or, perhaps you are in receipt of actual printed journals. Either way, I appreciate your pointing out the fact that it may take up to 4 weeks before we can expect an effect.

You asked if I am on any other medications. The only other psychiatric medication that I take is diazepam on an as-needed basis. In practice, this probably means taking no more than 25mg per week.

All the best!

keval

[SarahG]

Hi Keval

I actually take only 75mg (1 x 25mg and 2 x 25mg) alongside a daily dose of Sertraline and this has been a godsend too. When I first got very ill and was put on medication for GAD and Panic, I found the Sertraline started to work okish. The doctor then added the Pregabalin which by taking it in the doses above morning and evening has really helped with that awful morning anxiety. I would say it took about 2 weeks to really kick in and despite my doctor saying she would increase gradually, I never needed anymore that this "hit" to get me through the worst times.

I really hope it works for you... I've not read from anyone who it hasn't worked for yet although people have posted about cheaper alternatives to this drug which have not been so effective. I guess we are the lucky ones whose doctors agreed to give us with incredibly expensive drug because yes, it does work! Best of luck and stick with it.

Sarah xxx

[ems43]

Hi sarah, did you have start up side effects? I find that I feel ok on my evening dose, but for some reason the morning dose hits me really hard, I feel very spaced out for about 4 hours and don't really like the feeling. Did you experience this? I do hope this passes when i get used to it... have only been on it 7 days x

[ems43]

keval, the link the the bmj article is http://bestpractice.bmj.com/best-pra...r-standard.pdf