Pregabalin

Hi Elizabeth

Thanks for your reply.

I spoke to the Pharmacist yesterday and she said that people sometimes have problems with different brands due to the varying additives. I was half expecting her to say 'no, it's all in your mind because of your mental state ' like I usually get from these people! I am going to see if I can get hold of the Teva brand next week. I feel dreadful on the Lyrica brand.

I have spoken to my GP and Psychiatrist and they have said to reduce the dosage to either every other day or by splitting the capsule and taking half each day. Reducing is difficult because they are capsules rather than tablets and because am on the lowest dose possible. If the Teva brand is ok when I use it again. I may consider staying on it as it helps with the headaches I've been getting but will see how it goes.

Just wondering did your pain return once you stopped taking Pregabalin?

Hi Elizabeth,

Just wondering if you know how to taper easily from 25mgs? I've just been splitting the capsules and tipping some out but feel this is far from satisfactory as you don't get an equal measure as is taking one capsule every other day. Any idea?

Also do you know if your brain chemistry changes back once you stop Pregabalin?

I find this all pretty scary particularly as I came off Mirtazapine in August (tapering since May) and this has left me in a pretty shocking state with both my mental and physical health! I find the medical profession in the UK not much help at all!

Thank you.

Hi Vikki

Gosh, I will try to answer your questions one by one from my own experiences of 3 years on Pregabalin. Firstly, I agree fully about the very unnecessary Fillers used in the capsules. Who in their right mind would use Talc, a known cause in certain Cancers, in any medical capsules! If you use the water titration method of tapering (which I will explain fully and used myself) you will see the grit and talc in the dosage. I was on the Teva brand to start with but soon that was too expensive and I reacted badly to 2 or 3 other brands, Mylan, Zentiva and one I can't remember the name of. Splitting the capsules, as you rightly say, is not a good method so here is the Water titration way:

I will use a capsule dose of 25mg.

Open and empty capsule of contents into a glass dish. Add 25ml of warm water and stir together. Pregabalin is water soluble but you will see the additives in there - just ignore. Buy a simple syringe from local Chemist or Amazon. Best to use a 100ml which is marked in individual mls. Keep stirring the mix often.

If you want to try taking a little less daily, using the syringe take out 5ml and discard. Now you have 20mg/ml which you can split into 2 doses by taking 10ml out and putting into another container. This will give you two equal doses morning and evening. Keep second one in the fridge until use. Basically, you add the same amount in mls of warm water to mgs always. This is the most precise method. You can add a little fruit juice or cordial after splitting the dose if you can't stand the taste when you drink it.

Each capsule has a 12 hour life plus a half life (6hrs) so after 18 hours no Pregabalin remains in your system. This is why every other day is not an option as you start to go into withdrawals.

See how you go, and if you decide to continue tapering off you can do that coming down by a couple of mgs at a time for a week to stabilise until you can stop.

If you have not been on Pregabalin for very long, it should be easier on you. Being on the lowest dose your brain chemistry will not have suffered the lasting effects that higher doses over a long time do. I was on 200mg for 3 years and came off last October. I feel that my memory is getting much better, my sleep is normal and not drug induced, and my sciatic nerve pain does rear its head from time to time but is no longer all consuming as it was before I started on the drug. Just having clarity of thought again is wonderful because I did suffer mental confusion whilst on it.

I hope this is helpful to you Vikki and I haven't missed anything out. Please let me know how you get on and if you have further questions I will do my best to help.

Liz

Hi Elizabeth,

Thank you so much for your reply and the instructions for tapering are very much appreciated.

I have the syringes from my Mirtazapine tapering so was able to make the liquid for the first time yesterday. As I usually take my 25mg dose in the morning, I decided to take 20mgs of the liquid in one go rather than split the dose. Do you think it would be better to split the dose two as you suggest?

Also what do you think is a reasonable length of time to taper off the drug? When I was tapering Mirtazapine, they said something like 10% a month or 5% every 2 weeks but if I do this, it will take me far too long to get off!

Even if I do get hold of the Teva brand, I need to get off this drug. It's making me feel so awful now even at this low dose! My anxiety has got much worse, I feel exhausted all the time, I get palpitations at night and like you my memory is terrible and I have mental confusion. I'm even getting anxious and exhausted typing out this reply.

I really wished I'd not taken this drug. It seemed to be ok for a month, which I am not sure is due to the brand change or because there's a build of the drug in my system. Since then it's been dreadful, my symptoms have got worse and it's really set me back with my recovery from the damage done by Mirtazapine!

Any other thoughts or advice you can offer would be much appreciated?

Hi again Vikki

Do not take 20mg every 24 hours - you are putting yourself into withdrawals doing that as it is out of your system within 18 hours. This is partly why you are feeling so bad at the moment and more likely than the changing brands tbh. Take 10mg morning and 10mg at night for a while until you feel more stable. Then I suggest as you appear to be so sensitive to this drug that you come down at 10% each time....if you can't handle 10% try 5%. It may take a bit more time but your body is already dependent on Pregabalin and you need to listen to what it is telling you. So your schedule should look something like this:

Wednesday 16 January 10mg am and 10mg pm

Wednesday 23 January9mg am and 9mg pm

Stay on 9mg x 2 until you feel you can cope with another drop. You could then just take 8mg am and stay on 9mg pm until you stabilise. Then drop the night dose to 8mg to match the morning dose. This way your body has time to adjust to small drops each time. I cannot emphasise enough how important this is as doing it slowly and carefully really does minimise w/d's.

I know how desperate you feel to get off this drug but please take your time doing it. I admire you for sticking with the Mirtazapine taper and ask that you do the same with Pregabalin. When you get down to 2mg x 2 you will find it hard to drop the last 4mg's but just slow it down to suit how you feel until you are down to 1mg x 2. At this stage you can stop taking it without fear of repercussions and then allow time for the cravings to resolve themselves. The time it takes for any individual to return to their 'normal' differs from person to person. I was on 200mg a day and it took many months to do my taper - the hardest time was 10mg a day to coming off and I stopped when I got to 3mg a day without a problem. The brain takes a little time to start working for itself again, remember the drug closes off certain pathways and it takes time for the brain to kick back into action. This is an anti-convulsant, its original use, and not to be disrespected. Saying that I am noticeably improving daily and there is no reason for you to worry about things in that respect.

Diet wise eat as many of the brain foods that you can, good healthy fresh veggies and fruits etc. Also, keep hydrated, this is important and necessary. I think you will do just fine but I am only a post away if you need further support. Just let me know if I have left anything unanswered. Best wishes

Liz