Gabapentin to pregabalin

[Baz33]

Hello team, I had a 20 minute call with gp today to discuss the blackness of my mood.She was very thorough at looking at the full picture .

Has suggested reducing gabapentin to 100mg x 3 daily (now its 3 x 300mg ) for a week, have my bloods checked next Tuesday to see if the infusion has made a difference, then switch to pregabalin after I've weened off the gabapentin.

She suggested going back on the citalopram ,I said antidepressants drive rls and I mentioned trazadone,she said this was only used in special cases,I explained the interaction between antidepressants and rls with the exception of trazadone ,I also explained I'm not depressed ,my world is fine so her suggestion of talking therapy wasn't necessary , my mood has plummeted as a result of these meds or my low iron or both but it really is extreme!I've suffered with reactive depression as a result of bereavement and that was nothing like this ,this is almost irrational fear that's got a grip .

I'm just checking the doseage for withdrawal is right, as initially she did just tell me to swap over .

Please can someone help with the right course of action.

Thankyou in advance.

[SueJohnson]

You don't need to wean off gabapentin to switch to pregabalin. Divide what you are taking to get the correct amount. And I would NOT switch from 300 mg 3 times daily to 100 mg 3 times daily or you will have withdrawal symptoms. That's from 900 mg to 300 mg and normally you would reduce by 100 to 200 mg every 2 weeks to avoid withdrawal symptoms. And you don't take gabapentin 3 times a day. That's the way it is prescribed for pain and since it is prescribed off label for RLS that's the way it is described to take it in the leaflet. Instead it is only taken at night 600 mg 1 to 2 hours before bedtime and 300 mg 2 hours before that. since it is not well absorbed above 600 mg. Pregabalin can be taken all at one time 1 to 2 hours before bedtime.

I'm glad you were able to get the infusion and I hope you can convince your doctor to give you trazodone. It is not just used in special cases. This article explains that trazodone is the preferred one for RLS.

sleepreviewmag.com/sleep-di....

[Baz33 in reply to SueJohnson]

Thankyou as always sue

[Strike26 in reply to SueJohnson]

Hi Sue- I was interested in you saying above that Gabapentin is prescribed 3 times a day (in my case 3x 600mg) “for pain “. In my ignorance, when we discussed Ropinirole last year (yup-when you were right and I wasn’t!!!), I went to my doc and, obviously in error, requested my current arrangement (slowly building up to the max). I thought the Gabapentin was solely for the RLS. And, as you know it has had a massive positive effect on that. By contrast, it had no direct impact on pain from the RLS or other health issues - arthritis in my hips for example (recently, I have been using as low a dose as possible of co-dydramol, and that has helped a lot without affecting the RLS). Do you think this is just another example of what works for one person doesn’t for another? I ain’t changing- it does for me!!! And again, thank you- I wouldn’t be here, in a much better place if it wasn’t for this site and your advice. And to everyone else out there who suffers from this condition- keep on looking for your answer. It’s always darkest before the dawn.

[SueJohnson in reply to Strike26]

It is used for nerve pain. Nope - won't help arthritis.

[Joolsg]

I agree with SueJohnson. A straight switch to pregabalin is fine. No need to go through the suffering of tapering off gabapentin first.I hope the iron infusion starts to help AND that your GP listens to you about anti depressants. Trazodone is the only safe option here in the UK.

[Bazayan]

It's positive that your GP is taking a thoughtful approach by gradually reducing gabapentin and considering the switch to pregabalin.

[LotteM]

Sue has given you good advice re the switch from gabapentin to pregabalin and timing of taking the meds.

I also read from your post that you 'are not depressed'. That you feel terrible due to the situation. I have been in a similar position, and I agree, better improve the situation than add other meds. Additionally, several people have reported 'depression' as a side effect of gabapentin; I don't remember about pregabalin. No telling in advance for individuals which side effects you may get or not. I just hope the switch to pregabalin will solve most of your issues.

[Baz33 in reply to LotteM]

Depressed due to the medication, not the situation, so hopefully an increase in my iron levels will result in no meds at all but for now I'm hopeful that the swap will improve my mood .

[Hidden in reply to Baz33]

Pregabalin can also have a depressant effect, but not in every case. Hopefully it works better for you than gabapentin.