I've been on Pregabalin for about five weeks now. Started on 50mg, then 100mg, adding 25mg per week until this week taking 175mg. Anyway, as you may gather from the title I've started to suffer from vertigo, only for a minute or so at a time but two, three, maybe four times per day.
I know that vertigo is given as a possibke side effect. Just wanting to know will these get worse, better, stay the same? Is it possible to take medication for the vertigo attacks?
Just looking for advice and guidance please.
Thanks
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BurkerKing
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I doubt if it’s wise to take something for vertigo when it’s the side effect of another tablet.I wonder why your Pregabalin dose is increasing? I know it is said that it takes time to work & you need a certain amount but in fact mine worked on day 1 and at 50mg - and no placebo effect as was many years ago, given for another cause & no one knew then it worked for rls.
If it was me & I’d refuge gradually again to whatever dose doesn’t give you vertigo & see how that goes.
Is it definitely vertigo - it also affects balance in other ways
You are extermely lucky if taking only 50mg of pregabalin is controlling your RLS symptoms. It is unusual for such a low dose to work. Typically the minimum dose you'd expect to work is 150mg per day.
Because of initial side effects, the normal starting dose of pregabalin for RLS is 50 to 75mg. That is usually not enough so then the dose is gradually increased until it does work. That is why, presumably, BurkerKing has increased the dose.
If 175mg is the minimum dose that works for somebody then reducing it will mean that it's not going to control the RLS symptoms.
Thy side effects of drowsiness, dizziness and difficulty walking usually wear off after a few weeks so it's worth continuing the effective dose for a couple of months.
If after that time side effects are still intolerable then you might want to consider reducing the dose. However, that will mean the return of symptoms,. In which case you might consider that the pregabalin has failed.
All these drugs have side effects and you always have to consider whether the benefit of taking the drug is greater that the side effects.
Also just to clarify, other reasons for taking pregabalin include for nerve pain, focal epilepsy or anxiety disorder.
For these conditions pregabalin is usually presribed in split doses i.e. once or three times a day.
So for example the dose for nerve pain usually starts at 50mg three times a day (150mg per day) going up to 300mg or even 600mg/day.
However for RLS, pregabalin is only taken ONCE a day.
Yes, I know, thanks. Also to reduce the dose ifNerve pain only bothers you at night ( present but can ignore day time ) then can take only at night. The only condition one MUST take throughout the day is epilepsy. And yes for certain 50mg at night helped at 1st. Eventually I needed more, at 1st it was enough.
And sometimes there’s a balance to be struck between effectiveness &’side effects. Better but not perfect might be good enough. Not a fail but a partial success.!
Yes, you're right. It is a matter of balance between benefit and side effects, people have to find their own level. The balance is finding a level of symptoms that is tolerable for a tolerable level of side effects.
Hi, Your balance can be affected but it does get better. I presume you are taking the Pregabalin for RLS and if so then the deciding factor will be by how much your RLS symptoms are reduced by it. You are on a fairly low dose (I was on 300mg for many years and am now reducing it slowly). I hope this helps.
You only need to take enough for it to work, so if 175mg is working then increase it no further.
A typical effective dose is 150mg.
It does take time to get used to it hence when you first started it and when you inceased it, you would get side effects. One of them is vertigo. The other ones are drowsiness and possibly difficulty walking.
These side effects usually fade after a few weeks, so I would persevere.
These drugs always have side effects, you always have to consider whether the benefit of it is greater than the side effects. If it isn't then you'll have to consider other options.
Thanks for the advice. I am indeed taking the pregabalin for RLS, so once per day is the required frequency.
Currently I sleep for less than an hour before I have to get up and pace my living room. After an hour or two I can then sleep again...for 30 - 60 minutes (on the sofa). This has been my life for the past three months, so reducing my dosage is not an option at the moment as I have yet to find the dosage that will allow me to sleep for even four or five hours straight.
Glad to hear that tge side effects should diminish or even disappear given time.
1) What time do you fall asleep and what time do you take the pregabalin.
2) Previous treatment : Before starting the pregabalin, did you previously take any other RLS medication? If so what did you take, how much and when did you stop.
3) 150mg is typically the minimum effective dose. Many people need more than this. You may have to try increasing it further. The maximum recommended in the UK for RLS is 450mg.
The side effects should settle, but may re-appear again if you increase the dose.
I think it's good you have a goal, apparently of how many hours you'd like to sleep.
Looking at the sleep problem on its own.
I presume that the reason you wake up and have to pace is because of RLS symptoms, not simply JUST waking up. The latter is "early waking". If you didn't have to pace, it would be early waking.
This does support the view that the dose of pregabalin is insufficient. Once you take the pregabalin it reaches its maximum level in the blood after 2 hours. Thereafter it is eliminated from the blood at a rate which is measured as a "half life". All drugs are measured tbis way, but their half lives are all different.
The half life of pregablin is 6 hours.
As an illustration : If you take 100mg pregabalin 90% of it is absorbed. So after 2 hours there is about 90mg in your blood. After 6 hours, there;'s only 45mg left.
The other thing to consider that there is a minimum "therapeutic" level for the drug. That is an amount of the drug in the blood stream that is actually effective. This is different for different people.
As an illustration : If your therapeutic level is 70mg and you take 100mg. Then after 2 hours your level will be 90mg, i.e. more than 90mg. However hopefully you can see that it's going to go below the therapuetic level in less than 6 hours.
Hopefully you can work out that if your therapeutic level is higher, then the 100mg is not going to last as long and if its lower then 100mg will last longer.
Hopefully you can alsp see that therefore, increasing rhe dose will not simply make it more effective, it will make it effective for longer.
If your particular therapeutic level were known, there is probably an equation to work out how much pregabalin you'd need to have a threapeutic levels for 5 hours. I'm afraid I've forgotten all the calculus I used to know so can't help in that respect.
Other things you could consider.
1) Take other measures to treat your RLS symptoms. This mainly consists of
a) iron therapy : Iron deficiency is the main cause of RLS.
b) Avoid aggravating factors. These are mainly other medications, antidepressants, sedating antihistamines, some anti-emetics, neuroleptics, some antacids, some statins, beta blockers and OTHERS.
2) You may wish to add a benzodiazepine, if your Dr is willing. The typical one for RLS is clonazepam. This won't necessarily improve your RLS symptoms, but it may help you sleep through them. The downside of this is that a) They're potentially addictive and b) it has a half life of 30 hours so can leave you feeling drowsy the next day.
3) Not really of much help, but try some behavioural measures, commonly known as "sleep hygiene".
This may help because "chronic insomnia" can become a habit, which if broken by new habits can help with insomnia.
The dizziness and vertigo affected me quite badly for the first 2 months and then it gradually eased. I also used to get double vision for an hour every morning. After 3 months, either my body became used to it, or they subsided. If it's stopping the RLS I would stick with it for at least another 2 months.
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