Pregabalin & sleepiness

[Help1963]

Good morning everyone .. Looking for some advice on Pregabalin .. I take 150mg at 6pm and 300mg at 8.00pm to help control my RLS. But my god , the sleepiness- drowsiness in the morning is not great, so thinking i may drop down to 150mg at 6pm and 150mg at 8pm.. Has anyone else experienced this whilst on pregabalin (sleepiness & drowsiness )

[SueJohnson]

You will suffer from withdrawal symptoms from cutting it like that. You need to reduce by only 25 mg every 2 weeks.

You could instead ask for ritalin or adderall. By taking it in the morning it will wear off by night so you can sleep.

[teakabeagle]

Pregabalin and Gabapentin made me a zombie. Could barely drag myself through the day, was dizzy, falling, couldn’t concentrate, and ultimately severely depressed I didn’t get a lot of relief. After 3 months on each I called it quits

[Doversoul]

I take Pregabalin and my Sleep Clinic at Guys Hospital have diagnosed that I have RLS and PMLD.

The PLMD diagnosis is recent. Prior, I would take my Pregabalin at 8 pm along with Trazadone but along with RLS I suffered knee jerks and these stopped me from sleeping. If I did get off to sleep and a call of nature got me out of my slumber, when getting back to bed the knee and leg jerks and kicking would start again, So that night I had very little sleep.

Guys prescribed an Iron infusion in the hope that it would improve my Sleep. I had the infusion at St Thomas's Hospital last December, and the benefit has been a major reduction in the PLMD, The kicking and jerking have virtually ceased. Yipee!

Regarding the RLS, this is well controlled by 300mg of Pregabalin at night. If I were to take 450mg I would be a zombie the next morning unable to function.

The Trazadone gets me off to sleep at night.

Guys have prescribed my Pregabalin in 50,100 and 150mg tabs, This gives me options on how I take my Pregabalin. Over time it builds up in the body and I need to reduce the dose to 250mg at night and 50mg in the morning. That flexibility allows me to adjust the daily dose to suit my needs.

I know 450mg is considered the max dose for severe RLS treatment, but if you can't function then a lower dose and supplementary medication or an infusion of Iron could be a better life choice.

[amrob123 in reply to Doversoul]

Glad to hear that your RLS is well controlled.

I didn't realise until recently that psychotropic medications like pregabalin are best taken at a consistent dose. This is to maintain stable blood level and optimal therapeutic effects. Fluctuating doses can lead to greater side effects, withdrawal symptoms or reduced effectiveness.

Also pregabalin has a relatively short elimination half-life, (6 hours) so it shouldn't build up in your body.

[Help1963 in reply to amrob123]

Hey thanks for your reply, so should I be still taking my 3 x 150mg tablets in three divided - equal doses throughout the day / early evening? as I currently take 1 x tablet @ 6.00pm and the other two tablets @ 8.00pm as I have read that you should take it for the most part in the evening to assist with RLS , but as I said the sleepiness - hangover the next morning is sooo bad . Would 1 @ 12.00pm, 1 @ 4.00pm & 1 @ 8.00pm work better potentially? Value you input 😀

[amrob123 in reply to Help1963]

Hi there, my reply was actually to Doversoul and it relates more to adjusting the level of one's dose.

In answer to your question, while in one respect it's optimal to take pregabalin twice a day given its short half-life, for people with RLS/PLMD they don't actually need to take it twice a day. In their case, the benefits of doing so are likely outweighed by the downsides (i.e. taking more than one actually needs, taking it at a time when it's not required, feeling spaced out/dizzy in the daytime etcetera).

For RLS/PLMD, pregabalin is usually prescribed as one dose in the evening.

On 450mg, I'm not surprised that you're feeling so sedated the next morning.

I took 300mg nightly for a long time. I'm now down to 225mg as the lethargy, daytime fatigue and reduced motivation really got to me after a while. I also supplement with a very small dose of clonazepam (0.125mg) which helps my sleep more than pregabalin.

Depending on how long you've been on it, it's imperative that you withdraw slowly. It is recommended that reductions be no more than 10% of the starting dose each month. So, from 450mg, you'd reduce to 405mg, then to 365mg and so on. If you've been on it less than 6 months, you may get away with a less conservative taper schedule.

As my doctor keeps reminding me, with any medication, the aim is to find the minimum dose that works, and to only take it as long as it's needed.

[Doversoul in reply to amrob123]

Hello

Regarding your comments to my post and Help 1963.

If you know nothing about Pregabalin it is prescribed in a set amount tablet form.

Reducing the dose by 10% is an impossibility when the tablets are sized 25,50, 100 and 150mg.

I am under the care of the Sleep Disorders Clinic at Guys Hospital, London and it has prescribed my medication as 50,100 and 150mg tabs. This has allowed me to vary my daily dose of Pregabalin to suit my needs. We are all different and respond to medication individually. Most days I take 250mg at night 50mg in the morning, but there are times when I take 300mg at night, and although I may have RLS discomfort the next morning I keep the max dose of pregabalin to 300mg daily.

I have encountered Neurologists who have this fixed-dose attitude to medicating symptoms, and from my experience, the team at Guy's has got it right for me.

Concerning a 450mg daily dose of Pregabalin, this would be too much for me. However, if Help1964 RLS symptoms are as bad as the Mayo Clinic's worst RLS diagnosis, then I expect that is why such a high dose has been prescribed. Given that 450mg is causing problems, possibly a way forward would be to cut back the night dose to 350mg or 400mg, but to do either 50mg and 100mg would be required in addition to 150mg tablets,

I have suffered RLS since 1996. I have had three hospital sleep studies since then. RLS /PLMD will never leave me, and I am grateful that I don't have an even more terrible condition. I am comfortable with my Pregabalin medication and supplementary Iron fusion.

[amrob123 in reply to Doversoul]

Dose reductions are done via water titration. This allows for a 10% per month reduction.

[Coopersmum]

I am taking Pregabalin 150mg at 3pm and 200mg at 8pm. I am so tired at work even though I'm taking late afternoon and early evening. The good thing is I am sleeping well. I usually wake up once during the night with RLS. So much better sleep quality but tired enough to fall asleep at work a few times 😴 I was in 400mg in one dose on an evening, but changed the dose and times to try to help with the drowsiness with little success in afraid.