Pregabalin Dementia link?

[BoojaBooja]

This is a new one to worry about! Any truth in it?

[RiceyRiceRice]

ncbi.nlm.nih.gov/pmc/articl...

[SueJohnson]

I read the article and had a hard time understanding it as I am not a scientific researcher, but after puzzling over it for more than an hour what I came out with was:

1) The risk of dementia was 1.51%

2) it was higher in younger patients (age <50) than in the older patients

3) They "did not estimate the effect of the concomitant medications; confounders such as benzodiazepines, antihistamines, anticholinergics/antimuscarinics, tricyclic antidepressants (TCAs), muscle relaxants, opioids, proton pump inhibitors, antiepileptic drugs, antiparkinson drugs, and antipsychotics. ... it was likely that residual confounding effects could still exist due to those unmeasured variables," meaning that these could have contributed to the results and may have affected the risk of dementia

4) dementia did not mean Alzheimer's but rather just cognitive decline.

Since most RLS patients are over 50 and since suffering from RLS is terrible, and the risk is low and the extent of dementia is not defined, I will take that risk.

P.S. For anyone trying to read the article the DDD (average daily dose) is 300 mg pregabalin and 1800 mg gabapentin.

[Wordsworth99 in reply to SueJohnson]

Hi Sue, the risk ratio is aimed at answering the question: how many times higher is the risk of the outcome among people who are exposed to the risk factor. The way I interpret the results is that people who take gabapentin/pregabalin are about 1.5 times more likely to end up with dementia than people who don’t take these medications. It’s actually 1.45 times but I rounded it up for simplicity. Any statisticians in our group who can advise? 😀

[Wordsworth99 in reply to Wordsworth99]

Also, the risk of dementia associated with gabapentin or pregabalin exposure was significant in all age subgroups; however, it was higher in younger patients (age <50) than in the older patients (hazard ratio, 3.16. Which I think means that younger patients are 3.16 times more likely to end up with dementia than older patients.

[SueJohnson in reply to Wordsworth99]

I guess what I was saying is that since people who don't take gabapentin or pregabalin still have a 3.12% risk of dementia and that people who do take gabapentin or pregabalin have a 4.63% risk, they only have an increased risk from taking gabapentin or pregabalin for all ages of 4.63 minus 3.12 or 1.51%.

One of the known side effects of gabapentin can be memory loss and if one stops taking it as soon as they notice this in some cases their memory may improve or come back.

[Amrob]

It's most definitely something to be concerned about. I've read of such a link for some time now. Gabapentinoids are also reported to impair memory. It's part of the reason i advocate on this site for people to keep their dose of pregabalin/gabapentin as low as possible.

Edited to add : I'm under fifty so perhaps I perceive the longer term risks differently to someone decades older.

[RCHD in reply to Amrob]

I agree. My husband experienced very strange effects while he was on pregabalin. So severe we knew it was not good for him to be on. As with everything, everyone is affected differently. For him it was not a good medicine to use, brain wise.

[Beater in reply to Amrob]

I have been on it for 1.5 years now (pregabalin) and I has never adjusted to it. Can't remember if I have eaten sometimes and constantly forgetting my words and talking like a 2 year old. It has never helped with my pain in fact has contributed to it. Now I'm trying to taper off it but with no help from the Dr. who denies physical dependency or withdrawals. All the meds that have been prescribed have been my enemy and Dr.s refuse to listen or work with me to help, they just want to keep giving me meds that don't help but rather hinder my progress.

[SueJohnson in reply to Beater]

Definitely come off it. You need to do so very slowly to avoid withdrawal effects. Reduce by 25 mg every 2 weeks. If you do so you will have no withdrawal effects.

[Whippetmama]

There may be some truth to that. Speaking only from personal experience, I switched from gabapentin (after a very, very long time taking it) to pregabalin because it is less expensive in Mexico. My memory went so far down the tubes that I was concerned that I had dementia. Then someone (can't remember who) posted that they had noticed a decline in mental acuity when taking pregabalin and I had an AHA! moment. Switched back to gabapentin that night. My memory began to return almost immediately.

[RCHD in reply to Whippetmama]

It’s important to share these things, thank you.

[Beater in reply to Whippetmama]

Did you do a straight switch over or did you have to withdraw from pregabalin first? If straight switch, what was the ratio as pregabalin is stronger than gabapentin? If you don't mind sharing of course. Thank you.

[Whippetmama in reply to Beater]

I don't remember, sorry. It was several months ago. But I did do a straight switch following Sue's guidelines . I wish I had tapered off the gabapentin before switching -- I went into slight withdrawal. Switching back to gabapentin was no problem.

[SueJohnson in reply to Beater]

You can switch directly. Multiply the pregabalin amount by 6. If you need more than 600 mg take the extra 4 hours before bedtime as it is not as well absorbed above 600 mg. If you need more than 1200 mg, take the extra 6 hours before bedtime. If you take magnesium, even in a multivitamin, don't take it within 3 hours of the gabapentin as it reduces the absorption of the gabapentin. If you take calcium don't take it within 2 hours for the same reason.

However in your case, since you are having memory issues I would come off it. Why take a chance.

[glennaj5]

I can tell you that I was on Lyrica for several years for peripheral neuropathy and it was a miracle. I was finally able to sleep again. I did get RLS occasionally before there was meds for it, around 2005 to 2014. My doctor accidentally doubled the dosage, which I did not notice. I mentally went into the rabbit hole for about 3 years. It got to where couldn't problem solve anything. My family swore I was getting dementia. Long story short, I had a very smart pain management doctor who took me off of Lyrica and replaced it with Trokendi. After crappy withdrawals, I woke up and had gotten my memory back and could think so clearly, I was kind of spooked by how I was so intuitive and sharp things were. IIt took me a while before I found out that I had been taking too muchmedicine.much medicine. I have to think that there is truth in the dementia theory. Also, I never had relief for my rls from lyrica. If you have to take it for neuropathy, stay on small dosages. Sorry, I don't normally talk to anyone about any of these things anymore. I feel like I am rambling.

[Eryl]

I don't know about medications causing side effects but I do believe that if you rely on medications to control symptoms without changing your diet then that diet will cause more harm than just RLS.