Gabapentin vs. Pregabalin

Hi Everyone. I have recently seen my pain specialist and am changing from 600mg of gabapentin three times a day to 200mg pregabalin twice a day. Part of the swap is to see if pregabalin will be more effective for my pain and it's also to see if I will lose some of the fluid that I have retained with gabapentin. My weight is becoming an issue. Despite moderate exercise and a healthy diet I have gained 2 stone since starting on steroids (15mg pred and 75mcg fludrocortisone). Basically, I was wondering if anyone had experience of switching from gabapentin to pregabalin and how they found it? Was it a more effective painkiller, were there less side effects? (Oh, and will I be a supermodel size by the end of the week)! He he x


13 Replies

  • I too take pred - I and a lot of others on the PMR forums have either avoided weight gain or lost weight by drastically reducing our carbohydrate intake - I lost about 38lbs. Ordinary "healthy diets" didn't work for us - probably because there is a fair bit of carbohydrate in them with wholegrains and fruit. I see the difference - if I eat carbs for a time because I'm away from home and it is not so easy to control what appears on my plate I (at best) stop losing weight and (much more likely) put weight on. Once I get home to my normal selection of mountains of leafy and salad veg and meat/fish/cheese/eggs the weight is gone very quickly. It is definitely worth trying - pred changes the way our body processes carbs which is what leads to the weight gain and risk of diabetes. Cutting the carbs reduces both risks.

    Can't help over the gabapentin/pregabalin except to say I do know people who find one much better than the other - but both ways. It's a case of suck it and see!

  • My experience fits with PMRpro's (I haven't needed the gabapentin or pregabalin, but I'm on daily low dose pred + other daily lupus meds). I have to watch & limit ALL carbohydrates big time especially all processed carbohydrates...which includes ALL sugars (fruits in any form, processed sweeteners inc honey, starchy veg inc pulses & grains in any form). Basically I stick to an antiinflammation diet with emphasis on leafy salad veg + eggs + fish....and breakfast is muesli with probiotic yogurt + seeds & nuts. Eating this way helps all my body systems and keeps weight gain to a minimum

    🍀🍀🍀🍀 coco

  • Thanks guys! I have cut down drastically on carbs, especially as I have POTS so if I eat heavy meals I tend to feel quite ill. I eat a lot of fish and veg. I've gone gluten free mostly and swapped dairy milk for soya as it seems to suit my digestion better. What is news to me is that fruit might not be such a good idea. I've swapped out a lot of carbs and instead at work I eat a lot of grapes, apples, berries etc. Should I stop this? Is there a particular recipe book or lupus diet book that you would recommend? I bought a POTS recipe book but wasn't overly impressed so I've not bought a lupus book yet.

  • Other than berries there is a lot of sugar in fruit, especially grapes, apples and bananas. They can be the downfall of a diet if you eat a lot and, let's face it, for anyone, if a handful of something is the measure of a portion for you (what you can hold in the palm of your hand) then that means an apple or most bananas are 2 portions just like that. About 5 or 6 grapes is a portion (depending on the size) - and who eats just 5 grapes? They don't half mount up!

    I don't think you need a diet/recipe book - but there are a few sites that will tell you how much carb is in a particular food. The new Atkins site has a good section for that. Once you know what is in particular things then it is easy to plan to avoid them or swap them for something better. Baked goods are obvious - but fruit and root veg are not.

  • Hi I take pregabalen for nerve pain it is effective with the pain I have put on a lot off weight it also gives bad dreams and can make me intolerant and aggressive so I am limited to 150 twice a day I need something else also g

  • I was on Pregagablin, slowly upped from 25mg twice a day to 100mg twice a day. I gained a lot of weight from the start but when I started taking the 100mg I also became very light headed an spaced out. My GP slowly weaned me off it altogether as I wasn't noticing any real difference pain wise. I lost all the excess weight in around three months. Now I am on 30/500 co-codamol, 200mg Hydroxychloroquine and 50mg Amitriptyline. Feel that I do need something else to help with pain but so far haven't found anything that works / I tolerate.

  • I take pregabalin for pain, I remember the pain specialist saying that she was supposed to try me on gabapentin first as it's cheaper, but in her opinion pregabalin would be much better for me.

    Since then my doctor surgery wrote to all patients to check if they actually needed their pregabalin or if they were happy to try something cheaper.

    My observations on weight are as follows.

    About 15 years ago, before I suffered from any joint problems, quite out of the blue I got viral pneumonia, I was very sick and actually unable to work for 6 months.

    Anyway I gradually recovered but over the next year I steadily put on weight and developed allsorts of aches and pains. It didn't matter how I changed my diet or what I did. I put this down to taking less exercise as I was still very tired and the pain in my joints made me give up yoga.

    However now I can see that all my problems stem from that point.

    I'm very interested everybody's comments about restricted carbs , I have instinctively avoided these diets as I don't want to put my kidneys under any more pressure, but may reconsider.

    I know that I balloon when I take more steroids, but sometimes they are the only things that help.

    I'm on an impressive cocktail of drugs now, about half of which have the side effect of weight gain, I keep trying to lose weight but I think I tend to eat in response to pain so it's an uphill battle.

  • You may find these interesting - not saying you should use the low carb approach but it is relevant, depending on what your renal problems are

    You will have to register to read the second (it's free though).

  • Thanks PRMpro , I think I will discuss it with my gp.

    My renal function goes off quite regularly, also have problem with stones from time to time. Just being cautious.

  • Perfectly fair and right. It was to add another perspective on diet.

  • Yes thanks☺

  • My sister who suffered a medical misadventure with her thoracic nerve severed has been on both of these pain killers. The Pregabalin, in her instance, has been a huge improvement in terms of pain management. She has managed to loose some weight. Many meds tend to make your body slow down, so water retention and slowing down your digestive system as well as making you crave sugar. So we've noticed that she has better control over those issues on the Pregabalin. She is on other painkillers too but no cortisones. So everyone is different but hope you are pleasantly surprised and things improve. Diet and getting slimmer will have some help symptoms of course, but always a struggle in these situations.

    Pregabalin is very expensive here in NZ, so you are lucky to have the opportunity to try it. Fingers crossed it helps.

    All the best!

  • Hi Everyone, thanks for the comments. I thought I'd update you about how the Pregabalin trial went. Basically, it put me in a semi-comatose state! Initially it didn't give me any side effects so I thought "woohoo, pain relief and not drowsy and hopefully I'll ditch some of the fluid I'd retained." Two days later it was beginning to make me sleepy and then on the third day I had breakfast and took the pregabalin and then slept for 8 solid hours, only to be woken by my Mum who has come to stay for the week (we do this if I change my meds) but I usually live alone. She actually had to shake me to wake me up! She was even concerned that I'd accidentally overdosed, which I hadnt so for now, I've decided to go back to my previous dose of gabapentin and get a review from the pain clinic. I did give it 5 days and was only getting worse. Life seems easier if you can stay awake!

    My thoughts are that Pregabalin was effective but made me way too drowsy to do the important stuff like excersise, eat, move etc! I would try it again but on a much lower dose. Anyway, for now I am as stiff as a board as I've had such little mobility over this past week and my joints are very painful, worse than they have been in a long time. At least I am now able to string a sentence together and actually keep my eyes open, even if my eyeballs look a bit dazed!!!!

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