pregabalin side effects

[Minijackrussell]

I previously posted re my husband and severe rls. He started pregabalin 6 weeks ago as per Mayo Clinic guidelines and this forum. Initially he started 75mg with little effect and he gradually increased the dose to 175mg which seems to be controlling his rls and he is sleeping better. He has noticed two side effects 1) low mood at times and 2) 4kg weight gain. Has anyone else noticed these side effects and any suggestions re these. He’s less worried about weight gain as he will sort this through exercise etc more the low mood. He’s not normally depressed and doesn’t want to add in another medication if possible. Thanks for your help and support.

[Joolsg]

Low mood may also be a left over from dopamine agonists.These drugs increase dopamine in the brain. Dopamine is the 'feel good' pleasure hormone. When dopamine agonists are taken away- it plunges many people into depression/low mood for a long time. It can take over a year for the dopamine receptors to recover and repair.

Weight gain is a common side effect of pregabalin. It increases appetite.

Monitor for the next few months. Exercise will hopefully increase mood and help witj the weight gain.

If the mood does not improve- bear in mind all SSRI/SNRI and tricyclical anti depressants all worsen RLS.

Safe anti depressants are trazodone or Bupropion.

[Minijackrussell in reply to Joolsg]

Thanks Jools, Sue and Amrob

I showed my husband your replies and he appreciates the time you’ve taken to reply. He’s off the pramapexole at least 18 months now but had augmentation and an awful time with weaning it, could his neurological system still be recovering do you think from m the effects of augmentation this long after? He used gabapentin during withdrawal in high doses like 2700mg and didn’t like the side effects which also included low mood and decided eventually to come off that too. We realise that probably was more to do with wean of pramipexole and not the gabapentin which wasn’t very effective but we now know that is again associated with the withdraw of DA. His mood is defo worse with pregabalin but it hasn’t been fantastic before he went on either due to lack of sleep with severe rls!!! It’s a vicious circle and all drugs have good and bad effects. We discussed it today and are going to stick with the pregabalin and try and boost his mood with exercise and better diet now that he’s sleeping a bit better. We also thought of trying to reduce the dose even by 25mg if things are still the same in a few weeks or give gabapentin another try. He continues iron orally, magnesium, vit D3 and Vit b12 also. Thanks again and I’ll keep you posted.

[SueJohnson]

I agree with Joolsg. If his mood doesn't improve, and that can be a side effect of pregabalin, he might want to try switching to gabapentin. Although they are basically the same drug except you need to divide the doses, and the side effects are basically the same, some people find that the side effects that bother them on one don't bother them on the other. Multiply the pregabalin amount by 6 to get the correct dose. Since he needs more than 600 mg take the extra 4 hours before bedtime as it is not as well absorbed above 600 mg. If he needs more than 1200 mg, take the extra 6 hours before bedtime. If he takes magnesium, even in a multivitamin, don't take it within 3 hours of the gabapentin as it reduces the absorption of the gabapentin. If he takes calcium don't take it nor calcium-rich foods within 2 hours for the same reason.

[amrob123]

Low mood and weight gain are both commonly reported side effects of pregabalin. I don't know that low mood necessarily improves as one gets used to this drug. A couple of people that I know personally experienced this particular side effect and were advised by their doctor to come off it.

[Islay9]

I have experienced low mood and weight gain on gabapentin and now pregabalin.

Though it’s hard to tell if the low mood is from 5 years of no sleep and RLS.

Since the pregabalin is helping with the sleep I felt it was the price to pay.

I then really went downhill with my mood and ended up seeing a therapist. She recommended some changes in my life stressors that definitely helped but we also agreed for me to chat to GP about antidepressants.

Unfortunately he couldn’t give me bupropion (said that needed to be a psychiatrist) and I felt trazadone didn’t sound good as it makes you drowsy and I’m already pretty drowsy with pregabalin and dihydrocodeine.

Luckily for me I have adhd and had some medication that I’ve been waiting to start while trying to sort the RLS.

Since taking that my mood has dramatically improved.

Not sure if this helps your husband in anyway but I wanted to share my experience in case it does and also to validate his experience.

[Minijackrussell in reply to Islay9]

Thank you Islay9 for sharing your story with us. I’m glad you are getting sorted and appreciate you sharing.

[Minijackrussell in reply to Minijackrussell]

I forgot to ask what dose pregabalin are you taking? Tnx again

[Islay9 in reply to Minijackrussell]

450mg

[Minijackrussell in reply to Islay9]

Thanks, my hubbie on 175mg. That seems to be working for the sleeping and calming rls but he hates the low mood side effect. Its so tricky.

[Islay9 in reply to Minijackrussell]

Yes it is a juggle. It’s good he’s getting relief at a relatively low dose though.

I find the pregabalin helps me with sleep (kind of) but not necessarily the legs. That’s helped more by dihydrocodeine (for me).

[pyramidhiker]

I went from a DA to Pregabalin and have experienced weight gain (hungry ALL the time) but no mood problems at all. I have also found that on Pregabalin I am sleeping without the help of other medications or other helpful measures. The Pregabalin does not entirely remove the RLS symptoms but reduces them to a minor discomfort that can be overcome with sleep more easily. Also there is some limited research about using Vitamin E to address some of the side effects of Pregabalin. I seem a little clearer in the morning but still eating too much.

[SueJohnson in reply to pyramidhiker]

I may have mentioned this to you before. You might want to try switching to gabapentin. Although they are basically the same drug except you need to divide the doses, and the side effects are basically the same, some people find that the side effects that bother them on one don't bother them on the other. Multiply the pregabalin amount by 6 to get the correct dose. 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 nor calcium-rich foods within 2 hours for the same reason.

Pregabalin is more likely to cause weight gain.

[pyramidhiker in reply to SueJohnson]

Thanks Sue, I am quite happy on Pregabalin, particularly with my sleep improvement, which has never been good over the past 5 years. I am fairly lean so the added weight is not a big problem. Happy New Year Sue. Keep helping people, you do good work!!