Need some advice about Lyrica (pregabalin) and/or Neurontin (gabepentin).

[Trinitya]

A little background, I live in the USA. I've been on all sorts of antidepressants, benzos, and mood stabilizers with little no help. I've been diagnosed with major depression and social anxiety disorder. Eventually I quit taking my meds, none of have them have worked for me at all. They've made me suicidal, more depressed, reclusive, make me sleep hours and hours on end, or have little to no care for anything. I have a lot of problems leaving the house and talking to people as well. I'm absolutely on my wits end for the most part at this point.

One day I didn't have my Xanax and I came across an old bottle of Lyrica laying around and heard it helps with sleep (which is why I take Xanax for the most part, as I cannot function at all during the day with it) and man, I've gotten more than I expected. I had no anxiety at all and my depression just went away within an hour of taking 300MG. I actually wanted to talk to people, I wanted to go out of the house, I spoke to strangers with little to no social problems at all. My thoughts were clear, I was able to speak about anything. To conclude, I felt like a normal functioning member of society for the first time in my life in years.

Upon reading that the FDA doesn't approve it for GAD, it actually killed me inside a bit inside because for the first time I found something that could actually kick all the depression and anxiety that I have in daily life. However, I've heard people being prescribed it for anxiety in the US.

My question to you is, I'm thinking of asking my psych about it next week when I go to see her. I also heard of people being prescribed Gabapentin for GAD, but I heard it's a less potent version of it's brother, Pregabalin. How would I go about asking this? Is it wise to ask about it at all? Would I be turned down immediately? I have really good insurance, if that helps. This goes for either or, I'm not sure how well Gabapentin works for social anxiety, but I figured I'd ask you guys on what I can do here, if anything. Any extra tips or other info would also be greatly appreciated.

And of course, thanks for your time and response.

 

[Slow_Mobius]

http://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.160.3.533

You can show this to her. I haven't actually read any of the studies on pregabalin for GAD, but I know their have been some trials that have demonstrated efficacy and that it's not uncommonly prescribed off-label for that purpose. you might even be able to decrease your xanax use with it.

Just be aware that tolerance to gabapentinoids like pregabalin and gabapentin seems to build pretty rapidly, and some people experience very unpleasant WD. It might be a very useful medicaiton for you, but it's something to keep in mind. Don't rapidly increase your doses if you find yourself not getting the desired effect.

 

[Trinitya]

http://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.160.3.533

You can show this to her. I haven't actually read any of the studies on pregabalin for GAD, but I know their have been some trials that have demonstrated efficacy and that it's not uncommonly prescribed off-label for that purpose. you might even be able to decrease your xanax use with it.

Just be aware that tolerance to gabapentinoids like pregabalin and gabapentin seems to build pretty rapidly, and some people experience very unpleasant WD. It might be a very useful medicaiton for you, but it's something to keep in mind. Don't rapidly increase your doses if you find yourself not getting the desired effect.

Thank you for that link. I wasn't aware that it was prescribed off-label for GAD. I'm not very current with how that process works, but I figured that if the FDA doesn't approve a drug for something, that means you're unable to get it for that reason. I know that in Europe it is prescribed for GAD, at least, just wasn't sure about here.

Getting off of Xanax would be a god send. Benzos are a really nasty class of drugs and they have had little to no effect on my anxiety, but instead induce sleep which makes me unable to function most days. Anyway I'll keep in mind of the risks involved. I'm usually not one that is unsafe and don't see myself increasing it for the reason of no effects, so I will indeed be careful if this actually happens to work out for me. I just know that this is something that would truly benefit me in the long run.

Thanks for your response and the link, again.

 

[Slow_Mobius]

No problem. Drugs are prescribed for things they haven't been FDA approved for all the time. Pregabalin for GAD is less common than benzos or antidepressants, but it's definitely an option that physicians will consider. alot of physicians avoid it because it can be very expensive, but if you have good insurance, you should let your doctor know that the cost of the medication probably won't be a concern.

Good luck

 

[3methylmorphine]

Im UK based but one could only presume they previously probably didn't want to spend the money for Pregabalin on GAD etc as it was massively expensive when proprietary and under licence, however now it's no longer restricted licence they may be more incline?

Also, IMO it's like asking for Diamorphine tablets for a sprained ankle - is it really the safest and most effective option

 

[Slow_Mobius]

Im UK based but one could only presume they previously probably didn't want to spend the money for Pregabalin on GAD etc as it was massively expensive when proprietary and under licence, however now it's no longer restricted licence they may be more incline?

Also, IMO it's like asking for Diamorphine tablets for a sprained ankle - is it really the safest and most effective option

Depending on it's severity, GAD can be quite crippling. But you're right, it's definitely not a first line treatment.

 

[Trinitya]

Also, IMO it's like asking for Diamorphine tablets for a sprained ankle - is it really the safest and most effective option

Probably not, but I've been on more drugs for depression and GAD than I can count, ending up in my symptoms becoming worse or just not being effective whatsoever. This did, on the other hand, help alleviate everything and made me (as previously stated) feel like a normal functioning member of society. It's probably not the safest, but it's damn well effective in my experience, at least. I know there is quite a large circle of people who abuse this drug as a poor man's MDMA (or so I've observed) but that is not my intention here at all.

 

[knightworrier]

Here in my country as I have had anxiety and depression for 10 plus years. I have tried CBT, DBT and all kinds of anti-deppresants to anti psychotics... Too many to count. I have found a benzo that helps a bit but if I hadn't found some relief I think the doctors here would consider ECT before Pregabalin. (Pregab reallly only works well for nerve pain) I have pretty extreme daily pain and take Pregabalin.

It works for the pain but doesn't affect my anxiety or depression.

Make sure you have tried all lines of treatment before trying Lyrica. It's not an easy drug to come off either. I can think of a lot of benzos and anti psychotics that have helped more over the years.

Goodluck.

 

[pezcore]

I honestly think Gabapentin is a miracle drug when it comes to anxiety problems.. Even told my Dr as such. I just wish your body didnt get used to it so fast. it gives me relief for about a week and then i have to space out days in between to get the same therapeutic effects. I wish the pharmaceutical industry would invest in going down the road of gabapentin derivatives and like drugs to find something specifically geared towards anxiety and depression. Most Drs would rather you be on gabapentin versus a benzo, so id imagine your dr would be all for you using it. i have been told tho, by my pharmacist, that it might not be very long until gabapentin is scheduled. so better get it while its not so you have a history of prescription lol.

 

[Trinitya]

One last thing before my psychiatrist appointment on Friday.

Should I be honest with them and tell them that I tried it and it helped? Or would that land me in some legal trouble? To my knowledge pregabalin is schedule V. I've read and heard from friends that I should be honest and tell them about it. Is this a wise move or should I just keep it to myself?

 

[Slow_Mobius]

I would be honest with them. If they're not understanding.... they're probably not the best clinician. Also, it's really hard for psych specialists to help patients when you're not giving them full disclosure.

You can't get in any legal trouble. Your medical records are confidential.

 

[T. Calderone]

It wouldn't hurt to mention this to your doctor. The worst thing that could happen is they say no. I had found some gabapentin that my son left behind and I found it helpful for anxiety and back pain. I agree with pezcore though, with spacing out the days between usage. You may be better off with Lyrica even if it's more expensive. Let us know what your doctor says.

 

[Trinitya]

An update.

Saw my psych, she prescribed me gabapentin 100mg 3 times a day, then she's going to bump it up to 300mg 3 times a day in a month. The 100mg dosage 3 times a day isn't as effective as Pregabalin was, but that was expected. Still see a lot of improvement regardless.

Everything worked out well. She wouldn't prescribe Pregabalin because of it's strict use for nerve pain, which I kind of expected. Gabapentin works just as well, just not at the dosage I'm at, but it's a start in the right direction. Thanks to everyone who chimed in and tried to help me out!