Increasing pregabalin / gabapentin

I regularly see advice here to the effect that pregabalin (and by extension gabapentin?) needs to be given at least three weeks to establish whether it’s effective.

The advice also goes that when increasing dose, a couple of nights should be sufficient to establish effectiveness.

I would have thought that whether starting the medication anew, or increasing dose, the time taken to establish effectiveness would be about the same.

Is anyone able to explain this with regard to the evidence?

[Joolsg]

Good question.There aren't any hard and fast rules that I can find. Most NHS articles say that gabapentin / pregabalin take around 2 weeks to be effective for nerve pain, longer in some cases.

As gabapentin and pregabalin are prescribed 'off licence' for RLS, there have not been any detailed double blind placebo trials.

There is one study comparing pregabalin to Pramipexole, but it doesn't mention the time when pregabalin started to be effective.

Like all drugs for RLS, the effects and side effects will differ from person to person and there are very few large scale research studies to rely on.

It's why we desperately need world health authorities to teach this disease and do large scale studies on iron infusions, Alpha2Delta ligands and different opioids.

[Hidden in reply to Joolsg]

Thanks Jools, I agree there's so much more we could know in regards to the current suite of medications available.