Difference between Pregabalin and Gabapentin

Posted by karlag1953 @karlag1953, Mar 22, 2023

I am currently taking Pregabalin that was prescribed by my VA PCP, I have neuropathy in legs and feet. Which is questionable for 2 back/fusion surgeries or from Type 2 Diabetes. But, my question is what is the difference in Pregabalin and Gabapentin? What are the advantages/ disadvantages of either drug. I’ve been taking Pregabalin for years. Thank you so much for your comments.

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Hello @karlag1953, I also have neuropathy in the legs but I only have some numbness and minor tingling for symptoms which gabapentin doesn't help nor does any other drug. It's good asking questions and learning about different medications and treatment options that might be available for your neuropathy. Here are a couple of articles that may help answer your questions.

--- How Gabapentin Differs From Pregabalin: https://www.pharmacytimes.com/view/how-gabapentin-differs-from-pregabalin
--- Pregabalin and gabapentin in neuropathic pain management after spinal cord injury: a systematic review and meta-analysis: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6944364/

@jakedduck1 and others may have some thoughts on your question also. Have you asked your doctor or pharmacist if they can explain the difference to you or how one might be better than the other?

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That is a great question. A new doctor I went to is switching me from Gabapentin to Lyrica (which I believe is Pregabalin). I am wondering what the main difference would be.
Best of luck to you,
Kat

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Found this in the first of of the papers mentioned above - “ Horizant is a prodrug of gabapentin indicated for postherpetic neuralgia and restless leg syndrome. The recommended maintenance dose is 600 mg twice a day. Doses greater than 1200 mg daily are not recommended, as side effects increase without a corresponding increase in efficacy.7” —- Good to know for those of you with “restless leg syndrome”.
Also, the paper notes that Pregabalin is a better absorbed form of the medication which can be critical. It was for me because I had surgery to remove the lowest part of my small intestine was removed because of of non-Hodgkins Lymphoma!
Thanks for posting that paper. Have to read the other one. (N.B. None of my docs noted the fact of my surgery in prescribing either medication.) we have to stay alert ‼️

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has anyone read on mayo clinic common side effects from gabapentin is dementia

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One of the side effects of gabapentin is that it can cause mental confusion and forgetfulness. I have not heard that it can cause dementia but the side effects could be misdiagnosed as dementia.

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Thank you I really appreciate your question I have type 2 diabetes also have degenerative disc and back problems I have sciatica and legner pain and my feet burn from neuropathy I don't know the difference between the two drugs either I only have been on gabapentin and it seems to be not working quite as well even though the dose is much higher I take 600 mg three times a day my doctor recently added a third 300 mg at night time but when I wake up in the morning I'm very numb I'm almost afraid to take the third 300 mg at night time I wake up so out of it

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I was initially prescribed (in Aug 2020) Lyrica/Pregabalin for polyneuropathy; when I started travelling again post Covid, it was a hassle getting advanced pills for trips, I had to bring in my air tickets to prove I was travelling out of the country. Once I transferred the prescription to another State I stayed in for several weeks, and had no idea when I came home I could not transfer it back like other prescriptions, I had to get a new prescription. I had no idea that Lyrica is Schedule V medication, whereas Gabapentin is not. I have switched to Gabapentin, and honestly I have not seen anything better or worse than when I was on Lyrica. Much easier to get refills in advance of trips. Good luck, definitely talk to your doctor and pharmacist about the two.

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@snagydude

One of the side effects of gabapentin is that it can cause mental confusion and forgetfulness. I have not heard that it can cause dementia but the side effects could be misdiagnosed as dementia.

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Gabapentin also made me very tired. I actually thought it was my symptoms progressing but I switched to Lyrica and I’m not falling asleep midday. I did feel very confused at times but that was a symptom for me as well. It is hard to tell if it was worse with the Gabapentin. Overall it helped my pain and numbness tremendously. The Lyrica is not helping as much for me so far. Has anyone else switched he’s between these two medications?
Best of luck to you all,
Kat

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I can’t take gabapentin for neuropathy because it made me so dizzy I was always in danger of falling. Not good at 75 years old.

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@cjcatmom

I can’t take gabapentin for neuropathy because it made me so dizzy I was always in danger of falling. Not good at 75 years old.

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Hi - fortunately I do ok with Gabapentin, but I sympathize with your plight as several meds I’ve been prescribed over my 6 yrs of PN were like sedatives. I shelved them, wondering why on earth a doctor would prescribe a pill (to a person already having balance and walking issues) that increases the risk of falling and further damaging our life quality? I need to walk to the bathroom safely and be able to do more in my life than doze off all day in a Lazy-Boy recliner because of medication prescribed. Good luck finding the right help for you, I know there’s so much to try!

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