Pregabalin - not doing much

[lee_uk]

I’ve been on 225mg for about 4 weeks.which I take at 8:30pm and go to bed at 10:30pm. Unfortunately I then wake up about 4/5 times throughout the night. Should I keep trialing for another month? Or think about switching to Gabapentin? Or as an experiment take some of my dosage earlier in the evening? Thanks

[LotteM]

Hi Lee. I just read in your earlier posts that you stopped your low dose pramipexole about 3 mo ago. The withdrawal from stopping the pramipexole should have eased more or less by now. Accepting that, I know of several options to play around and try a little longer on the pegabalin.

Firstly, you are still below the maximum of the dose range that is generally effective (150-300mg). But I just read in Madlegs post that Dr Buchfuhrer mentions a maximum of 450mg. So it is an option to talk to your doctor to increase the dose. Make sure you get smaller dosed tablets allowing you to play fine-tune your dose.

Secondly, I know that it can increase effectiveness to split larger doses of gabapentin, a similar medicine. I don't know whether this also applies to pregabalin, but it may be worth to try. Split your current dose in half (dependent on what sized tablet you have available) and play around with timing, I would start with at least 1h apart and the 2nd dose at least 1h before bedtime.

Thirdly,if the pregabalin helps but not sufficiently, discuss with your doctor to add a small amount if a painkiller. You could start by otc cocodamol. If you need something stronger discuss tramadol or oxycontin.

Finally, although they are in the same class of medicines (alpha2delta ligands) some people respond better to gabapentin than to pregabalin and vice versa. If the other options fail (I hope not!) it may be worth a try.

Good luck. Let us know how you get on.

[lee_uk in reply to LotteM]

Thank you LotteM, that’s a great help. I will try the splitting of the dosage to start with.

[LotteM in reply to lee_uk]

Thanks 😊. Sounds like a wise first step.

[Hidden]

Hi, Lotte gives some good suggestions. If you're waking early, I'd also suggest taking a dose LATER. So if you split the dose take one as normal and take one just as you go to bed, that might help.

Taking pregabalin is a balancing act, a compromise between the severity of symptoms and severity of side effects.

If you can get to sleep at 10 30 and wake up 4 or 5 times then go back to sleep this isn't at all ideal, but it's better than not getting to sleep and/or waking only once, i.e. after 3 hours then that's it. It may be that at some point you'll find it better to accept that this is the best it's going to get.

I find I sleep better in spring and autumn. The short summer nights are too short and the long winter nights are too long.

The quality and amount of light we're exposed to can have a significant impact on our sleep. So sleep hygiene including light exposure may be of help. This involves ensuring you're exposed to full spectrum light at least 2 hours during the day and avoid it at night.

So no LED or bright fuourescent lighting, no TV between 8.30 and 10.30, no use of devices with full spectrum backlit displays, PC, laptop, tablet etc or use devices where the display can be adjusted to filter out blue wavelengths.

[lee_uk in reply to Hidden]

I spilt the dosage in 3 last night 830-10:30 and actually had a reasonable night. Might be down to exhaustion but hoping its something else. Will experiment some more. This heat wave won’t be helping any of us!

[Hidden in reply to lee_uk]

Great, that sounds like an improvement.

Keep cool 😊

[Gabbii]

I take 250mg Pregabalin at 8 pm and it works well but if I eat sweets or drink alcohol in the evening my rls gets worse and it is hard to get a good night's sleep.

[Hidden in reply to Gabbii]

Alcohol and sweets are triggers.

If you can't resist sweets, try having a protein rich snack at bedtime. This can help counteract the sugar.

[lee_uk]

2 months down the line and 300mg Pregabalin really isn’t doing anything. How do I switch over to Gabapentin? Can I do it straight away or do I have to wean myself off the pregabalin (fingers crossed I don’t).

[Joolsg in reply to lee_uk]

As they’re the same class of med you can switch straight over. I was on Gabapentin 900mg and tramadol 100mg and it didn’t help at all so switched straight over to 25mg Oxycontin and 150mg of pregabalin. They worked better for me.

I hope you find Gabapentin helps but if not, do see your doctor and maybe add a low dose opioid.

[lee_uk in reply to Joolsg]

Thanks Joolsg, will give the Gabapentin a try first. Slightly worried about moving onto a low dose opioid. Now if only I could get an appointment!