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Pregabalin (Lyrica, Gerica, Pregaben)

Pregabalin is an anticonvulsant (antiepileptic drug) that alleviates nerve pain. Off-label, it can be used as an anxiolytic (relieve anxiety). Read more for highlights of pregabalin use.

Pregabalin: use, side effects, precautions, and more

Pregabalin is used worldwide to manage seizures and pain disorders: this medication has analgesic, anticonvulsant, and anxiolytic effects. In the USA, it was FDA-approved in 2004.

Here, pregabalin is a Schedule V controlled drug which means it has the lowest potential for abuse and may incur limited psychological and physical dependence.

Schedule V substances are distributed or dispensed for medical purposes only. Issued prescriptions for the drug may be transmitted to the pharmacy orally (by the prescribing practitioner), in writing, or electronically. Refills are to be authorized on the prescription or by call-in.

Pregabalin is available under brand names and as a generic. Here are some trade names of the medication:

Mechanism of action

Structurally, pregabalin is similar to GABA (gamma-aminobutyric acid): an inhibitory neurotransmitter, made lipophilic for swifter transportation through the blood-brain barrier.. Nevertheless, the drug molecules do not bind directly to GABA-A or GABA-B receptors.

Neither it is active at the sodium channels, opiate, dopamine, and serotonin receptors. Unlike many other pain relievers, such as NSAIDs (e.g. ibuprofen), pregabalin does not alter cyclooxygenase activity.

The exact action mechanism of pregabalin has not been described. In animal models of nerve damage, the medication inhibited the release of pro-nociceptive neurotransmitters—compounds responsible for the perception of pain.

It is possible that its analgesic and anticonvulsant effects are connected to binding with the alpha2-delta subunit and subsequently reduced release of excitatory neurotransmitters—compounds necessary to pass down a neural signal.

Indications and use

Pregabalin is FDA-approved for:

Because pregabalin shows promising potential in trials with patients who have anxiety disorders, it is often used off-label (without FDA indication) as an anxiolytic.

An interesting fact: there is study testing flavored low-dose pregabalin solutions in cats to alleviate anxiety and fear induced by transportation and visits to veterinary specialists: a novel treatment method was considered both effective and safe.

Other examples of off-label use include:


Pregabalin is taken orally (by mouth). It is available in capsules of varying strength:

For those who require precise dosage calculation or have trouble swallowing, there is a 20 mg/ mL oral solution. The medication can be administered with or without food.

The recommended dose depends on the health condition and varies from 50-75 mg (restless legs syndrome, anxiety) to 600 mg (partial onset seizures, neuropathic pain) daily.

If necessary, the patient’s healthcare provider may adjust it for higher treatment efficacy. If pregabalin is discontinued, it is recommended to taper the medication gradually rather than dropping it abruptly.

Side effects

The most prevalent adverse reactions to pregabalin include:

Possible severe side effects of pregabalin:

Chronic use, especially in patients with a history of drug abuse, may cause physical and psychological dependence.


Pregabalin is a medication that has anticonvulsant, anxiolytic, and analgesic properties. It is frequently used to treat seizures, neuropathic pain, and mental health issues. In the USA, the drug is regulated (Schedule V). Pregabalin therapy necessitates ongoing monitoring of the patient's health.