What is the major difference between pregabalin and gabapentin?

Posted by mikead63 @mikead63, Apr 18, 2025

I have idiopathic peripheral neuropathy (diagnosed in January of this year). I was prescribed gabapentin 2-3 hours before bedtime. At this point I am at 600mg which helps while I know it's a low dose for many, at this point it's fine for me. I had not heard of pregabalin until today when I was researching info. in Pharmacy Times. I know that pregabalin is quickly absorbed while gabapentin is absorbed around 3 hours post dose. My question is: IS ANYONE ON PREGABALIN? If so, how is that working out??

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Profile picture for bajjerfan @bajjerfan

@mister1

If I miss a dose I don't really notice it.

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@bajjerfan That’s the crazy part how it works for some and not others. If what worked for one worked for all this wouldn’t be such a busy blog. Well here’s hoping we all find what works for us!!

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Profile picture for bajjerfan @bajjerfan

I've been on 75mg 3 X per day for a little over 4 and a half years. I am now in the process of down dosing to 50mg 3 X per day. If i feel ok I may just go down to 25mg 3 X per day. My major issues were chest pain typical of diabetic neuropathy and all body itching. So far neither has reappeared.

As an aside while doing some yard work my lower back felt better than it has in a LOONNGGG time. I hope that portends good news ahead.

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@bajjerfan
I may have to backtrack. This past Sunday I'm pretty sure I took a double dose at one point. When I get up I usually take my a.m. dose along with tramadol, Lasix and Dyazide. I also set out the same thing for the next morning. At lunchtime by accident I took the morning dose again. I normally have a pre-prepared dosage for lunchtime as well as bedtime. I didn't notice much until early evening when I went out to do some yard work. My lower back was nowhere near as sore as it would normally be when outside on my feet. I may end up increasing my dose rather than dropping it or even eliminating it.

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I'm sorry that you are having so much discomfort. You might look at Choline 500mg (You have to take 3 a day). Not for your pain but for your word search problems. It has helped me. Neuropathy makes a real case for "less is more"

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I cut back on the strength of a few OTC meds I was taking that cause, at least for me, tiredness throughout the day. I also sat down with my Doc and discussed cutting back on my Gabapentin from 600 mg to 300 mg to see how that goes. I know I'm on a low dose compared to many others but the 600 mg. seemed to do the trick initially.

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Profile picture for Mariette R. @marietter

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

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@marietter Gabapentin is also known to cause Dementia. I stopped taking it months ago.

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Profile picture for bini41 @bini41

@marietter Gabapentin is also known to cause Dementia. I stopped taking it months ago.

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@bini41 Has not been scientifically confirmed as of yet. Check the NIH website . (National Institute of Health. Psychiatric Institute of Health.
Potential effects may affect under a certain age group. 30 to 64 with mild cognitive impairment. Seniors have a 24-26% chance of cognitive impairment, but perhaps more dizziness and loss of balance .
More studies are ongoing, but to date Gabapentin has not been confirmed by science to directly cause dementia .

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Profile picture for Bob Ellis @bob7316

@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.

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@bob7316 Wise choice for your particular effects while taking these.

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Profile picture for Debbie @dbeshears1

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.

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@dbeshears1 I will be 85 in October. I've been taking gabapentin for about 5 years now, since I got neuropathy from chemo for breast cancer. I take 300mg. 3times a day, and I don't have dementia. I lead a full life and I still travel around the country having adventures.

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Profile picture for Debbie @dbeshears1

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.

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@dbeshears1
Hi, Debbie ~
So nice to come across your post! I think you have something that works for you and I sure wouldn't add the Pregabalin which is what I take. Initially my doctor prescribed Gabapentin but the side effects were immediate and scary (depression, crying). I do think the Pregabalin causes weight gain (sigh!) but that is less painful than nerve pain. (And that's saying a lot.)
I hope you are doing well otherwise. I'd like to have more energy and get more done in a day but I'm thankful that my meds (Pregab. and Tramadol, taken together) keep me able to live a pretty normal life.
Blessings and all good wishes to you!
Barb

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My research shows that pregablin has been tested more than gabapentin and shows more success for pain relief. However it has to be at least 300 mg per day to be more effective than the placebo, its effectiveness increases at the 600 mg per day level.

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