What is the major difference between pregabalin and gabapentin?

I have been on Gabapentin for 10 years and while it's not a cure, it has been controlling my symptoms as well as I've learned to expect. A couple of years ago, a doctor asked ME if I wanted to add pregabalin. I asked HIM why I should add it on top of Gabapentin, to tell me what additional benefits it would offer. He said "I'm not sure, but a lot of my patients seem to prefer it. But if you're OK on Gabapentin, maybe we shouldn't add it". That struck me as weird for him to not be able to tell me how it could improve me, and for him not to know more about it since he was offering it. I had heard from others that it made them gain weight, so I certainly didn't want that possible side effect for something that wasn't going to help my Neuropathy and was going to cost me $$$. So we agreed there was no need for me to add the Pregabalin. But all of us respond differently, I'm not saying that it might be better for other people.

@dbeshears1

You wouldn't add it you would replace the GabaPentin with Pregabalin. Wouldn't make sense to take both. It may control things better. Only way to know is try switching.

""generally not recommended. Because both medications belong to the same drug class (gabapentinoids) and work in very similar ways, combining them doubles up on the same mechanism without providing unique benefits, significantly raising the risk of severe side effects.""

@bajjerfan You are absolutely right - thinking back to then, I do recall he offered a “switch” from Gabapentin to Pregabalin, not adding it. But since I was stable on Gabapentin with no complaints for what was 8 years at that time, and he couldn’t explain any improvements I could get from switching, we agreed that switching because some others liked it wasn’t good rationale for me since I was doing fine with Gabapentin. Gabapentin is basically free in my plan as well, so paying $$$ for no known improvement opportunities for me (and possible weight gain) wasn’t very sensible for me. If Gabapentin stopped working or started giving me side effects after these 10 years I’ve now been on it, I would certainly consider switching.

For me Gabapentin was about as useless as a back pocket on a T shirt.

@bajjerfan I get it, I’ve heard many folks say they had issues with Gabapentin. I’m one of the fortunate who got the intended measurable outcomes without negative side effects. Like everything else with this unfortunate idiopathic (aka idiotic) PN, there’s no one-size fits all when it comes to what works for us individually. But I sure like hearing about them, because I’ve been able to experiment with some ideas here that (medicine or tools) that have improved my quality of life tremendously.

Recently, I read where gabapentin causes dementia like symptoms also.

@quilterfingers . Is your diet high in animal protein because that's where B12 comes from. Plenty of people eat too much carbo. It's cheap. Best B12 supplement is METHYLCOBALAMIN.

@bob7316
With all politeness I am correcting a spelled word here.
Dementia not
“dementure”.

@bob7316 Sorry to hear of the side effects. But your information is useful. Thank you for sharing it.

@suetex
You are right the Gabapentin and the Pregabalin both give people Dementia like symptoms so I have finally decided to not use either of them. I am tapering off the Pregabalin now and I am just going to try to treat my Neuropathy with just ordinary Panadol. I know that it does not help much with Neuropathy but it helps me get back to sleep. I can not stand the Dementia any longer and so I am stopping everything just to see how I go. I have found that the tablets are worse than my condition. They have me walking around with a brain fog that leaves me unable to have a decent conversation with anybody. I am hoping that I come good after getting off the
Pregabalin.