Switch to Gabapentin from Pregabalin

[wantokporo]

I am sick and tired of daytime sedation from the 150 mg of pregabalin I take. It successfully treats my PLMD along with careful attention to food/drink triggers and has for three years or so. But it is hard to imagine the rest of my life fighting to stay awake. I have tried gabapentin twice. Both times it caused depression before I got to an effective dose. However pregabalin also causes depression when I have changed dosages for one reason or another and then passes after several days. Because I was increasing the gabapentin every four days to get to an effective dose that it might be different if I could just switch over from pregabalin? Can I switch directly? I am also thinking of trying Horizant (expensive though it is) if gabapentin wouldn't work. Thanks in advance.

[SueJohnson]

You can switch directly. 900 mg gabapentin would be equivalent to your 150 mg pregabalin. Take 600 mg 1 to 2 hours before bed and 300 mg 2 hours before that as it is not well absorbed above 600 mg. A safe antidepressant is trazodone which even helps some people with RLS.

[SueJohnson]

If you are under 65, Horizant has a prescription savings card which makes it inexpensive. originalText

[wantokporo in reply to SueJohnson]

Thanks but I am 75. What a strange deal?

[Hidden]

I am taking 300mg pregabalin and a small amount of clonazepam. I too experience considerable daytime sedation.

About 2 months ago, I started an ultra low dose of naltrexone ( 0.5mg taken sublingually).

I haven't noticed any improvement in my PLMD/RLS (that can take months) but it has given me more daytime energy.

I did stop it while I had Covid and am yet to resume it but I fully intend to as i feel it really helps.

I also need to take it in the morning as it gives me insomnia otherwise.