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Pregabalin (Lyrica) addiction: causes, symptoms, side effects, and treatment

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Pregabalin (Lyrica) addiction: causes, symptoms, side effects, and treatment

Pregabalin (Lyrica) addiction refers to a condition where individuals develop a compulsive and harmful pattern of use of the anticonvulsant medication pregabalin, primarily used to treat neuropathic pain, seizures, and certain types of nerve disorders.

The causes of pregabalin addiction encompass neurochemical effects, self-medication, history of substance abuse, current or previous mental conditions, extended use of pregabalin, ease of accessibility, and social and environmental influences.

The symptoms of pregabalin addiction are taking higher doses than prescribed and taking doses more frequently than prescribed. Additionally, individuals often develop increased tolerance, cravings, and loss of control. Despite facing negative consequences, continued use persists, marked by a preoccupation with obtaining pregabalin at the expense of social engagement. Unsuccessful attempts to quit highlight the struggle with physical and psychological dependence, leading to withdrawal symptoms and mood changes.

The common side effects of pregabalin addiction include dizziness and drowsiness, coordination problems, gastrointestinal issues, increased appetite and weight gain, dry mouth, blurred vision, and weak or shallow breathing. Additionally, individuals addicted to pregabalin often experience cognitive impairment, edema (swelling), mood changes, severe allergic reactions, and suicidal thoughts.

The available treatments for pregabalin addiction are medical detoxification, inpatient or outpatient rehabilitation programs, counseling and therapy, support groups, dual diagnosis treatment, family therapy, aftercare, and relapse prevention.

What is Pregabalin (Lyrica) addiction?

Pregabalin (Lyrica) addiction is a condition characterized by the compulsive and problematic use of the medication pregabalin, primarily used for treating seizures and providing pain relief. 

Pregabalin was originally approved by the Food and Drug Administration (FDA) as an antiepileptic drug, known as anticonvulsant, in December 2004. Additionally, this drug is employed in alleviating pain stemming from conditions such as post-herpetic neuralgia caused by herpes zoster, nerve pain associated with diabetes (diabetic neuropathy), fibromyalgia, and pain resulting from spinal cord injuries, as outlined in the article on “Pregabalin,” last updated in August 2023.

As per the US Drug Enforcement Administration (DEA) regulatory classification of drugs from July 2018, highlighted in the “Drug Scheduling,”  Lyrica, known by its generic name pregabalin, is a Schedule V substance due to its limited potential for misuse. This categorization places it in a group of drugs, substances, or chemicals recognized for having a lower potential for abuse compared to those in Schedule IV.

However, extended use of pregabalin leads to the development of tolerance, where higher doses are needed to achieve the desired euphoric effects. When physical dependence sets in,  it manifests as cravings and unwanted withdrawal symptoms when the drug is not used.Pregabalin poses a higher potential for abuse particularly among individuals using opioid medications or with a history of substance abuse, as stated in the StatPeals’ article on “Pregabalin,” last updated in November 2022.

How common is Pregabalin addiction?

Pregabalin addiction is common, with a 1.6% gabapentinoid abuse prevalence observed in the general population, as reported by the researchers of the 2017 study “Abuse and Misuse of Pregabalin and Gabapentin,” published in the Drugs journal. However, among opioid abusers, the rates of gabapentinoid abuse vary significantly, ranging from 3% to 68%.

An international adverse event database identified 11,940 cases of gabapentinoid abuse between 2004 and 2015, with over 75% of these reports occurring since 2012.

A 2015 study “Pregabalin abuse amongst opioid substitution treatment patients” conducted at the National Drug Treatment Centre’s (NDTC) Drug Analysis Laboratory and published in the Irish Medical Journal, revealed that among 440 opioid substitution patients, 39 tested positive for pregabalin, constituting 9.2% of the toll. Only 10 patients had valid prescriptions for pregabalin, indicating an estimated misuse rate of 7.0%.

This study confirmed the occurrence of pregabalin abuse within the addiction services population, emphasizing the necessity for vigilant monitoring of this emerging issue concerning prescription drug misuse.Over the ten years from 2012 to 2021, the study “Rise of Pregabalin Poisoning and Abuse Cases in Serbia: A Ten-Year Retrospective Study,” published in April 2023, observed a rising trend in pregabalin consumption, with the first case of abuse detected in 2016 and the highest number of abuse-related poisonings recorded in 2020 (30 cases). Pregabalin abuse occurred in 27.8% (84 out of 302 cases).

What are the causes of Pregabalin addiction?

The potential causes of pregabalin addiction involve a combination of biological, psychological, and environmental factors. 

The causes of pregabalin addiction are listed below.

  • Neurochemical effects: Pregabalin attaches to presynaptic voltage-gated calcium channels within central nervous system tissues specifically at the alpha-2-delta subunit. This binding leads to a decrease in calcium influx triggered by depolarization in neurons, consequently lowering the release of excitatory neurotransmitters, as stated in the StatPeals’ article on “Pregabalin,” last updated in November 2022. Such a mechanism explains the anticonvulsant and analgesic properties of the drug. Additionally, the drug exhibits anxiolytic and sedative properties, contributing to pregabalin’s addictive potential.
  • Self-medication: A study “Misuse of Pregabalin: a qualitative study from a patient’s perspective” published in the BMC Public Health in July 2023, explored the misuse of pregabalin in the context of self-medication among first-generation immigrants in Belgium. Many of these individuals, dealing with challenging or traumatic migration experiences turned to pregabalin as a form of self-medication for anxiety-depressive disorders and chronic pain, despite these conditions not being within the approved therapeutic indications for the drug. Conversely, some individuals were self-medicating for generalized anxiety disorder or pain with a neuropathic component. This misuse is a result of the drug’s perceived ability to help users manage their daily situations.
  • History of substance abuse: Individuals with a history of substance abuse or addiction are more prone to misusing pregabalin. According to Schjerning O. et al.’s 2016 study “Abuse Potential of Pregabalin: A Systematic Review,” most case reports related to pregabalin abuse featured individuals with a prior history of substance abuse, and parallelly, epidemiological studies identified instances of abuse, particularly among those with a history of opioid abuse. 
  • Current or previous mental conditions: Co-occurring mental health disorders, such as anxiety or depression, contribute to the risk of pregabalin addiction.
  • Extended use of pregabalin: Prolonged use of pregabalin leads to the development of tolerance, where higher doses are needed to achieve the same effects. Dependence is often observed with the extended use of the drug, increasing the risk of addiction.
  • Ease of accessibility: The ease of obtaining pregabalin, whether through a legitimate prescription or by illicit means contributes to its misuse and addiction. According to the 2023 study “Misuse of Pregabalin: a qualitative study from a patient’s perspective,” published in the BMC Public Health, the widespread availability of pregabalin in illicit markets, its effects combining recreational and therapeutic properties, and its energizing characteristics have made it a favored substance for highly mobile individuals dependent on their ability to cope with daily stressors. Additionally,  the lack of stringent prescription regulations further contributes to its widespread misuse.
  • Social and environmental influences: Peer pressure, societal norms, and environmental stressors play a role in initiating and perpetuating pregabalin misuse. The 2022 study “Some psychiatric comorbidity among patients with substance abuse disorder related to pregabalin” published in the Middle East Current Psychiatry highlights the impact of social and psychological factors on drug misuse behavior. It reveals that individuals mostly misuse pregabalin for self-treatment of anxiety, to conform to peer pressure, or to cope with depression.

Why is Pregabalin (Lyrica) addictive?

Pregabalin (Lyrica) is addictive due to its potential to produce euphoria and sedation, as well as its ability to enhance the effects of other drugs, particularly opioids and benzodiazepines. These effects lead to increased risks of dependence and misuse.

Pregabalin affects the neurotransmitter systems, particularly the GABA (gamma-aminobutyric acid) and glutamate systems, creating a potential risk for abuse, as indicated in Schjerning O. et al.’s 2016 study “Abuse Potential of Pregabalin: A Systematic Review”.

Pregabalin’s mechanism for inducing feelings of euphoria and relaxation involves interaction with the brain’s dopaminergic system. 2021 research on the “Involvement of the dopaminergic system in the reward-related behavior of pregabalin,” published in the scientific reports, indicates that pregabalin increases dopamine release in specific areas of the brain, such as the nucleus accumbens, through glutamate neurotransmission.

Glutamate release is linked to dopaminergic neurotransmission. This interaction is important for regulating various aspects of brain function, including those related to motivation, reward processing, and addiction. This increase in dopamine levels is thought to contribute to the euphoric effects and drug’s potential for abuse and addiction.

Can Lyrica be addictive if taken as prescribed?

Liquid Pregabalin bottle.

Yes, Lyrica can be addictive if taken as prescribed, particularly in higher doses or for extended periods. Its prolonged use often leads to physical dependence and addiction particularly among individuals with a history of substance abuse, as stated in the 2017 study “How addictive are gabapentin and pregabalin? A systematic review,” published in the European Neuropsychopharmacology.

The 2012 research by Martinotti G. on “Pregabalin in clinical psychiatry and addiction: pros and cons” indicated that pregabalin is prone to be linked with abuse, particularly in individuals with a history of alcohol and substance dependence. Controlled clinical studies involving over 5500 patients have revealed that 4% of those treated with pregabalin, developed pregabalin abuse. Additionally, upon sudden or swift discontinuation of pregabalin, a group of patients experienced symptoms like nausea, insomnia, diarrhea, or headache.

Researchers advise that in patients with a history of substance use disorder (SUD), gabapentinoids, including pregabalin, should either be avoided entirely or, if deemed essential, administered with caution. This caution should involve rigorous therapeutic monitoring and attentive prescription supervision.

What are the symptoms of Pregabalin addiction?

The symptoms of pregabalin addiction vary from person to person, depending on the severity of the addiction, the dose, duration of use, and individual differences.

The symptoms of pregabalin addiction are listed below.

  • Taking higher doses than prescribed: Individuals with pregabalin addiction symptoms often surpass the recommended doses, escalating their consumption to levels beyond what is medically advised. This behavior often stems from a desire to intensify the drug’s effects or counteract increased tolerance.
  • Taking doses more frequently than prescribed: A manifestation of pregabalin addiction involves individuals deviating from prescribed usage schedules by taking the medication more frequently than directed. This pattern signifies a loss of control over the frequency of drug intake, potentially exacerbating the risk of dependence.
  • Increased tolerance: Over time, individuals addicted to pregabalin develop drug tolerance and need higher doses to achieve the desired effects, as their body becomes accustomed to the drug.
  • Non-medical pregabalin use: Pregabalin addicts often use the drug for purposes other than its intended medical use. This includes taking it recreationally or in pursuit of non-therapeutic effects, highlighting a divergence from the prescribed therapeutic goals.
  • Mixing pregabalin with other drugs: Individuals exhibiting symptoms of pregabalin addiction engage in the dangerous practice of mixing it with other drugs, seeking enhanced effects. This polydrug use increases the risk of adverse interactions and potential harm to physical and mental well-being.
  • Cravings: Pregabalin addiction is characterized by a constant and intense desire, or craving, to use the drug. This persistent longing is typically driven by the individual’s need to experience the pleasurable effects associated with pregabalin use.
  • Loss of control: Individuals struggling with pregabalin addiction often exhibit a loss of control over their drug use. Despite facing negative consequences, such as health issues or strained relationships, they struggle to limit or control their consumption of pregabalin.
  • Secretive behavior: Pregabalin addicts deliberately hide or keep secret the extent, frequency, or reasons behind their consumption of the drug. This behavior involves providing false information to healthcare providers, hiding the drug, or misleading friends and family about the quantity and purpose of their pregabalin consumption. Such behavior is driven by a desire to maintain the addiction without facing judgment, intervention, or potential consequences from others.
  • Continued use despite negative consequences: Pregabalin addiction is marked by a pattern where individuals persist in using the drug despite experiencing adverse effects on their physical health, mental well-being, relationships, or overall functioning.
  • Preoccupation with obtaining pregabalin: Addiction to pregabalin is characterized by a preoccupation with acquiring the drug. Individuals devote a significant amount of time and effort to obtaining, using, or recovering from the effects of pregabalin, often at the expense of other crucial activities.
  • Social withdrawal: Pregabalin addiction frequently leads to social withdrawal, with individuals neglecting social, occupational, or recreational activities as they prioritize the drug over interpersonal interactions.
  • Unsuccessful attempts to quit: Individuals struggling with pregabalin addiction find it challenging to quit or cut down on their use, despite making repeated attempts to do so.
  • Physical and psychological dependence: Pregabalin addiction results in both physical and psychological dependence. Individuals rely on the drug to function normally, and when not using it, they experience withdrawal symptoms, further reinforcing the dependence.
  • Withdrawal symptoms: Pregabalin addiction is often accompanied by withdrawal symptoms upon the drug discontinuation. These symptoms, which include insomnia, nausea, or heightened anxiety, reflect the physical and psychological dependence that has developed due to prolonged misuse of pregabalin.
  • Mood changes: Misuse of pregabalin contributes to mood changes in individuals, leading to mood swings, irritability, and alterations in overall emotional well-being as a direct consequence of addiction.
  • Doctor shopping or prescription fraud: Pregabalin addiction often involves engaging in deceptive practices, such as doctor shopping or prescription fraud. Individuals seek multiple prescriptions from different healthcare providers or attempt to falsify prescriptions to ensure a steady supply of the drug.

What are the side effects of Pregabalin addiction?

The side effects of pregabalin addiction are listed below.

  • Dizziness and drowsiness: Pregabalin addiction disrupts the central nervous system (CNS), leading to heightened levels of dizziness and drowsiness. These effects result from the drug’s impact on neurotransmitters, causing sedation and impaired alertness.
  • Coordination problems: Pregabalin addiction interferes with the body’s neurological function, resulting in coordination problems. The drug’s impact on the CNS affects motor skills and coordination, contributing to movement and physical control difficulties.
  • Gastrointestinal issues: Pregabalin addiction often leads to gastrointestinal issues, including nausea, digestive disturbances, and constipation. The drug’s impact on neurotransmitters disrupts normal digestive processes, resulting in discomfort and gastrointestinal complications.
  • Increased appetite and weight gain: Pregabalin addiction is associated with an increased appetite and subsequent weight gain. According to 2012 research by Martinotti G. on “Pregabalin in clinical psychiatry and addiction: pros and cons,” approximately one in six patients undergoing treatment with pregabalin experience a weight gain exceeding 7% of their initial body weight within a period of 2 to 12 months. This indicates a significant proportion of individuals affected by notable weight gain as a side effect of pregabalin treatment during this timeframe.
  • Dry mouth: Pregabalin addiction causes dry mouth. This side effect results from the drug’s influence on salivary gland function, leading to reduced saliva production and a persistent feeling of dryness in the mouth.
  • Blurred vision: This side effect is attributed to the drug’s impact on neurotransmitters affecting visual perception, leading to a lack of clarity and focus in eyesight.
  • Weak or shallow breathing: Pregabalin addiction depresses the respiratory system, leading to weak or shallow breathing. When taken with other CNS depressants, such as opioids, the drug’s impact on neural pathways controlling breathing results in respiratory suppression.
  • Cognitive impairment: In a randomized controlled trial assessing perioperative pregabalin, cognitive functions were examined through neurocognitive tests measuring memory, attention, and executive functions, as highlighted in the ASA Publications’ 2019 issue on the “Cognitive Effects of Perioperative Pregabalin: Secondary Exploratory Analysis of a Randomized Placebo-controlled Study,” The results indicated a notable decline in performance, especially in inhibition and working memory, with pregabalin compared to the placebo. Specifically, the spatial working memory within the error test revealed a significant impairment, impacting visuospatial working memory and strategic decision-making essential for higher cognitive functions.
  • Edema (swelling): Pregabalin contributes to fluid retention in the body, leading to edema or swelling in different parts. This side effect is linked to alterations in the body’s fluid balance and vascular function induced by prolonged misuse of the drug.
  • Mood changes: Pregabalin addiction often induces mood changes, including fluctuations in mood stability and emotional well-being. This occurs due to the drug’s impact on neurotransmitters involved in mood regulation.
  • Severe allergic reactions: The researchers of the 2013 study “Pregabalin hypersensitivity in a patient treated for postherpetic neuralgia,” published in the Indian Journal of Pharmacology, presented a case of drug hypersensitivity syndrome (DHS) caused by pregabalin, prescribed for postherpetic neuralgia. A 40-year-old male patient was admitted due to intense, stabbing pain in his left loin. One week prior, the patient developed a vesicular rash in the same area. Alongside the rash, the patient also experienced a burning sensation. The preliminary diagnosis suggested a probable hypersensitivity to pregabalin.
  • Suicidal thoughts: As outlined in the StatPeals’ article on “Pregabalin,” last updated in November 2022, antiepileptic medications, including pregabalin, elevate the likelihood of suicidal thoughts or behavior. Therefore, it is recommended to carefully monitor patients receiving pregabalin treatment for indications of new or exacerbated depression, suicidal thoughts or actions, and any other alterations in mood or behavior.

What are the complications of Pregabalin addiction?

The complications of pregabalin addiction are listed below.

  • Physical health issues: Prolonged pregabalin addiction contributes to physical health problems such as gastrointestinal disturbances, dizziness, coordination difficulties, and potential weight gain. Combining pregabalin with other CNS depressants like opioids leads to respiratory complications, especially in individuals with respiratory issues or the elderly.
  • Cognitive impairment: Extended misuse of pregabalin results in cognitive impairments, affecting memory, attention, and overall mental clarity.
  • Psychological effects: Pregabalin addiction has a profound effect on mental health, including mood swings, anxiety, irritability, and emotional instability.
  • Social and occupational impairment: Individuals grappling with pregabalin addiction often neglect social, occupational, or recreational activities, leading to strained relationships and impaired functioning in daily life.
  • Financial strain: Addiction to pregabalin has significant financial implications for individuals, as they prioritize obtaining the drug over meeting other important financial obligations. This results in financial difficulties as finances are diverted towards acquiring the drug, potentially leading to debt, unpaid bills, or the inability to afford basic necessities.
  • Legal consequences: Illicit acquisition or distribution of pregabalin, often associated with addiction, leads to legal repercussions.
  • Impact on relationships: Pregabalin addiction strains relationships with family, friends, and colleagues, as the individual’s focus shifts towards obtaining and using the drug.

Can you overdose on Pregabalin (Lyrica)?

Yes, you can overdose on pregabalin (Lyrica) if it is used beyond the prescribed or recommended dosage.

The highest recommended dosage for Lyrica is 600 mg daily, as stated in the article on “Lyrica Dosage,” updated in June 2023. As per StatPearls’ article on “Pregabalin,” last updated in November 2022, the largest accidental overdose of pregabalin was reached at 8000 mg. Nevertheless, this occurrence did not lead to noteworthy clinical effects.

A 2020 study by Isoardi KZ. et al., titled “Pregabalin poisoning and rising recreational use: a retrospective observational series” concluded that overdosing on pregabalin typically results in mild sedation and, in rare cases, seizures, rather than severe toxicity. Coma is more likely when pregabalin is taken with sedating substances.

A more recent study highlighted in the Frontiers in Medicine 2023 publication titled “Case report: A comatose patient with pregabalin overdose successfully treated with continuous renal replacement therapy,” also indicates that overdose of pregabalin normally leads to mild symptoms, and coma is uncommon unless the patient has also taken sedatives or has preexisting kidney problems.

In combination with other drugs such as opioids, Lyrica overdose results in serious medical complications and poses a life-threatening situation. According to the 2020 study “Pregabalin Abuse in Combination With Other Drugs: Monitoring Among Methadone Patients,” published in the Frontiers in Psychiatry, concurrently using pregabalin and opioids often intensifies the depressant effects on the CNS. This effect leads to a potentially life-threatening interaction and is linked to a notable rise in mortality.

What are the symptoms of Pregabalin (Lyrica) withdrawal?

The symptoms of pregabalin (Lyrica) withdrawal are listed below.

  • Insomnia: Pregabalin withdrawal disrupts sleep patterns, leading to insomnia characterized by difficulty falling asleep or staying asleep. A 2021 study led by Ishikawa H. et al., titled “Pregabalin withdrawal in patients without psychiatric disorders taking a regular dose of pregabalin: A case series and literature review,” presented three cases of pregabalin withdrawal in individuals without psychiatric disorders. The patients, who used to take regular pregabalin doses, experienced psychiatric symptoms, including insomnia and anxiety, upon the sudden substance withdrawal.
  • Anxiety and nervousness: The abrupt discontinuation of pregabalin disrupts the balance of neurotransmitters in the brain, contributing to heightened feelings of anxiety and nervousness. Withdrawal from pregabalin leads individuals to experience an increased sense of worry, unease, or apprehension.
  • Nausea: Nausea is a common withdrawal symptom during discontinuation of pregabalin. Individuals feel an unpleasant sensation in the stomach, often accompanied by the urge to vomit.
  • Diarrhea: Diarrhea is a gastrointestinal symptom associated with pregabalin withdrawal. It involves an increase in the frequency of bowel movements with loose or watery stool. This digestive disturbance is part of the body’s response as it adjusts to the absence of pregabalin.
  • Headache: Withdrawal from pregabalin triggers headaches, manifesting as persistent or throbbing head pain. The exact mechanism behind these headaches is not fully understood but is believed to be linked to changes in neurotransmitter activity and the nervous system’s adaptation to the absence of the drug.
  • New or worsening seizure: During withdrawal from pregabalin addiction, individuals often experience new or worsening seizures due to the abrupt cessation of the drug, which disrupts the balance of neurotransmitters in the brain. Pregabalin works by stabilizing abnormal electrical activity in the brain, so sudden discontinuation leads to rebound hyperexcitability and increased seizure risk.
  • Sweating (hyperhidrosis): Excessive sweating, or hyperhidrosis, is a physiological response during pregabalin withdrawal. The authors of the study “Pregabalin Abuse and the Risks Associated for Patients with a Previous History of Substance Misuse,” published in the Journal of Addiction Research & Therapy in February 2013, detailed the case of an individual who developed dependence on pregabalin. Despite undergoing medically supervised detoxification, he faced persistent cravings for pregabalin and withdrawal symptoms, including unrest, sweating, arterial hypertension, and tremor.
  • Fatigue: Fatigue is a prevalent withdrawal symptom, characterized by persistent tiredness and a lack of energy. Individuals struggle with low stamina and find routine activities more challenging during this phase of readjustment.
  • Muscle pain: A case study “Pregabalin-associated Discontinuation Symptoms: A Case Report” published in the journal Cureus in 2018, presented a case of an old woman who was hospitalized with chest pain, severe weakness in her legs, body tremors, heightened anxiety, and insomnia. These symptoms emerged during the pregabalin tapering process, indicating changes in neurotransmitter function as the body adapts to the absence of the drug.

What are the available treatments for Pregabalin addiction?

The available treatments for pregabalin addiction are listed below.

  • Medical detoxification: Gradual tapering of pregabalin dosage under medical supervision helps minimize withdrawal symptoms, allowing the body to adjust slowly.
  • Inpatient or outpatient rehabilitation programs: Inpatient programs provide a structured and monitored environment, offering round-the-clock medical support during the initial stages of recovery. Outpatient programs provide flexibility for individuals to receive treatment while maintaining daily life commitments, attending therapy sessions, and gradually reintegrating into their routine.
  • Counseling and therapy: Cognitive-behavioral therapy (CBT) is effective for pregabalin addiction as it addresses distorted thought patterns and behaviors associated with addiction, promoting healthier coping mechanisms. Individual counseling and group therapy provide tailored support, helping individuals explore the root causes of addiction and build a strong support network.
  • Support groups: 12-step programs and SMART recovery offer peer support and a sense of community. These groups provide a structured framework for recovery, emphasizing shared experiences, accountability, and ongoing motivation to abstain from pregabalin use.
  • Dual diagnosis treatment: For individuals with co-occurring mental health disorders, such as anxiety or depression, integrated treatment addresses both addiction and mental health issues concurrently. This holistic approach ensures a comprehensive understanding of the individual’s needs and supports overall well-being.
  • Family therapy: Involving family members in the treatment process helps address family dynamics and provides a support system for the individual in recovery. Family therapy fosters open communication, understanding, and collaborative efforts toward sustained recovery.
  • Aftercare and relapse prevention: Developing a personalized aftercare plan ensures continued support post-treatment. Ongoing therapy, participation in support groups, and access to relapse prevention tools contribute to long-term recovery success, helping individuals navigate challenges beyond the initial treatment phase.

What is the difference between Pregabalin addiction and Gabapentin addiction?

Pregabalin pills bottles.

The difference between pregabalin addiction and gabapentin addiction lies in their effects on the body, susceptibility to misuse, absorption rate, and onset of action.

Both gabapentin and pregabalin belong to the drug class known as gabapentinoids with similar mechanisms of action, but they are distinct chemical compounds. Lyrica is a brand name for pregabalin, while brand names of generic gabapentin include Neurontin, Gralise, and Horizant.

Pregabalin is a Schedule V controlled substance, while gabapentin is not classified as a controlled substance. Although gabapentin is not classified as a controlled substance, it also has the potential for abuse, and thus the risk of gabapentin addiction.

According to the 2017 study “How addictive are gabapentin and pregabalin? A systematic review,” published in the European Neuropsychopharmacology, pregabalin exhibits a higher level of addictive potential compared to gabapentin in terms of the intensity of behavioral dependence symptoms, the shift from prescription use to self-administration, and the persistence of self-administration behaviors.

As stated in the article on “Lyrica vs Gabapentin: What’s the difference?”, last updated in May 2023, pregabalin demonstrates a faster absorption rate and onset of action compared to gabapentin. Pregabalin reaches its highest concentration approximately one hour after ingestion, while gabapentin reaches its peak concentration within a span of 3 to 4 hours after intake.