GABApentin/ pregabalin? Same ?? - Restless Legs Syn...

Restless Legs Syndrome

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GABApentin/ pregabalin? Same ??

RCHD profile image
RCHD
15 Replies

So are pregabalin and GABApentin the same drugs with different names? I am a bit worried as my husband just started GABApentin. He used pregabalin years ago but it made him very depressed he had to stop it immediately..

So the neurologist currently prescribed, GABApentin, stilnox and madopar to use at this time. Not sure if anyone has experience with this. He has had extreme case of RLS

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RCHD
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15 Replies

Hi, Pregabalin is a "precursor" of gabapentin, i.e. once it gets into the brain, it's turned into gabapentin. Gabapentin then is in effect the same as pregabalin. Side effects are more or less the same. Pregabalin is more potent than gabapentin however, so depending on the dose.

Some peoplle react differently to gabapentin than they do to pregabalin. I guess your husband will just have to wait and see. Please be aware that intial side effects of gabapentin can wear off after a few weeks, so unless he becomes depressed quite quickly, give it a trial for a few weeks at least

Stilnox (zolpidem) is useful to help with sleep, without leaving you drowsy the next day. Some people have a problem with it in that it can cause sleepwalking and this can be dangerous Keep an eye out!

"Z" drugs are quite addictive, not recommended for long term use.

Madopar contains levodopa is rarely used for RLS especially since the dopamine agonists were found to help RLS. It can be usd for intermittent RLS i.e. where symptoms only occur about once a week.

For severe RLS which requires a daily medication it is NOT recommended because of the extremely high risk of dopaminergic augmentation a major complication of dopaminergic drugs. Madopar is prescribed almost exclusively for Parkinson's disease.

Dopamine agonists are now used for RLS when a dopaminergic drug is indicated. This is either pramipexole, ropinirole or rotigotine. Unfortunately these too also have a risk of augmentation, but not as great as levodopa.

If your husband has taken a dopaminergic agent before, levopdopa should be avoided. If he hasn't a dopamine agonist would be less risky.

I hope that as well as drugs, iron therapy and avolidance of aggravating factors has been discussed with him.

In some cases, appropriate iron therapy can eliminate the need for drugs at all.

RCHD profile image
RCHD in reply to

Thank you so much . This was a very helpful response. He has used pramipexole in the recent past and Also a few years ago which is a dopamine agonist. I’m trying to learn as much as I can . He only took one dose of madopar and doesn’t feel it’s for him. Not only that he had a splitting headache!! I also feel it’s not the right thing.

in reply toRCHD

Glad I've been of some help.

RCHD profile image
RCHD in reply to

You should open up a clinic.. you have more knowledge than most doctors 🙏🏾

in reply toRCHD

Too old!

Pagan707 profile image
Pagan707

Too me they are basically the same. I was on Gabapentin for a few weeks a good few years ago and came off it. I don’t remember it causing me depression but just didn’t feel right with it at all. My GP prescribed Duluxotine as an alternative which is an anti- Depressant with nerve healing properties. I was on that for many years but came off it as I felt it was not helping and that I needed a drug specific for depression. I don’t think we are warned how strong this drugs are. I found it harder to come off Duluxotine than morphine.

RCHD profile image
RCHD in reply toPagan707

Yes agreed these drugs are strong. My husband ultimately doesn’t want to be on anything. But needs help currently to gain back sleep he lost during opiate detox. Thanks for the reply

in reply toPagan707

Strange that your doctor should prescirbe duloxetine as an alternative to gabapentin, If you have RLS, gabapentin can treat it. Duloxetine like mopst antidperessants can make RLS worse.

In any event an antidepressant won't relieve RLS symptoms.

RCHD profile image
RCHD in reply to

Yes I heard from this very good you tube from Cleveland Ohio restless leg center that anything “anti “ anti depression etc.. anti histamine, will all aggravated restless leg.

howlinwoolf profile image
howlinwoolf

Yes, they are essentially the same. I would not suggest just "trying it out" or "wait and see." Both pregabalin and gabapentin are extremely difficult to wothdraw from and can induce significant long-term neuralgia as well as cognitive issues that pretty much mimic dementia.

These symptoms do not go away with time. In fact, for me and many others it just keeps getting worse. The withdrawal can be worse than benzodiazipines or opiates. I have been weaning off the 3600mg of gabapentin I was on for years, prescribed initially for RLS FOR A YEAR.

I hope that he can find another option because both of those drugs are horrible.

RCHD profile image
RCHD in reply tohowlinwoolf

Ok thank you for sharing this. He’s taking 600 mg for the last 2 days. I appreciate you telling your experience. It’s important to know.

RCHD profile image
RCHD in reply tohowlinwoolf

Also how long were you on Gaba ?

in reply toRCHD

Gabapentin and pregabalin don't suit everybody.

Some people it's true have a bad experience of them and they are dependency producing so they're not always easy to withdraw from.

There are warnings in fact that they can be addictive. However, for them to be addictive you really have to abuse them and take quite high doses.

The maximum recommended dose for gabapentin is 2700mg and some specialists say only 2400mg. Taking significantly more than this is bound to lead to more severe side effects, worse withdrawal symptoms and greater risk of addiction.

A doctor who would prescribe 3600mg for RLS is irresponsible.

There are long term consequences to all drugs.

As for any other drug you have to weigh up if the benefits of a drug are more than the side effects or risks.

The three classes of meds most effective for RLS are gabapentoids, opioids and dopamine agonists, which unfortunately doesn't leave many options.

You will find many more horrendous tales of peoples' experiences of dopamine agonists than there are of the gabapentinoids.

RCHD profile image
RCHD in reply to

What’s your opinion of tramadol ... and what drugs are the least problem ?My husband is getting some iron rests back soon. I actually hope he can get something out if that. He does crave red meat meat and has been a vegetarian almost whole life. But now eating meats. But they say sometimes it’s not about how much iron you eat because the body is not absorbing it.

Resi profile image
Resi

I’m the opposite gabapentine made me low and depressed and I’m on pregablin now for six weeks and everything seems ok for now

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