Lyrica (pregabalin) for alcohol and benzodiazepine dependence

[Greg]

There is evidence that pregabalin (Lyrica) in the dose range of 150 to 600 mg per day is helpful in cases of alcohol and benzodiazepine dependence. It is not reliable for acute withdrawal from alcohol by the sound of things, but seems promising for longer-term treatment once someone is detoxified.

Pregabalin for alcohol dependence: a critical review of the literature. - PubMed - NCBI

Efficacy and safety of pregabalin in the treatment of alcohol and benzodiazepine dependence. - PubMed - NCBI

This is not surprising, since there have been reports of gabapentin being helpful in alcohol dependence and it has the same mechanism of action in the brain that pregabalin has.

[neophyte]

i've read pregabalin is basically a "stronger" version of gabapentin whatever that means, im sure the pharmacology is different. That said, i can tell you gabapentin will help benzo and probably alcohol withdrawal, but with alcohol withdrawal since its so acute and short lived, benzos are the preferred method. if youre addicted to both. my advice is get on baclofen while tapering off off benzos with a long acting benzodiazepine like valium following the ashton protocol. The baclofen will eventually calm down the cravings for alcohol and theres no magic cure for benzo dependence but to slowly ween yourself off.

im not a doctor, and this is a serious matter to your health, so take it with a grain of salt, seek help from a psychaitrist who specialises in addiction. I'm just relating my experience as i have been addicted to both at times.

edit - there is also a lot of anecdotal claims that gabapentin and pregabalin have issues with tolerance and dependence, the time frame of use of the drug to get to that state is not well understood by me. so keep that in mind.

[YouKayBee]

The stuff I found indicated Lyrica comes with dependency issues, not an ideal switch.

[Ne/Neva Eva]

Yeah. Pregabalin is not a safe drug for people with addiction. It's been shown to increase aggression and impulsive behavior, with dramatic mood swings and changes in personality in the people who were taking it for Parkinson's. Can't find the research to back that up, but it's out there.

Gabapentin doesn't have the same dangerous profile, at all. And has been shown to help people curb craving and quit drinking. There's more information about it here:

Neurontin (gabapentin) - Neurontin (gabapentin) - The End of my Addiction

[neophyte]

I've heard anecdotes online that gabapentin can cause dependence and withdrawal symptoms. Is this something that can be taken safely indefinitely to curb cravings without risk of tolerance and withdrawal?

[Molly78]

I've been doing some research on gabapentin. I haven't found any evidence of tolerance - it's a licensed longstanding anti-epileptic treatment, so you might expect that tolerance in clinical use would have been uncovered by now? Also the definition of tolerance is usually applied to drugs which produce a "high" of some sort. As I understand it, gaba can be used recreationally in high doses to get a buzz. In this situation I expect tolerance will develop, and higher doses will be needed to get the same buzz.

Withdrawal of treatment suddenly is certainly a cause for concern. Many reports of people suffering severe anxiety and other unpleasant symptoms when stopping suddenly. But that's the same with baclofen.

Over to terryk if he is still around on this site.......

[terryk]

https://www.mywayout.org/community/medication-research-and-support/17689-gabapentin-2.html#post1565761

-tk

[neophyte]

Thanks TK

looks to me like it's still not clear if using gabapentin at a prescribed dose and not abused, is a useful medication to curb cravings to alcohol based on those links. im very curious, ive had trouble with benzodiazepine dependence before (being an idiot) and used gabapentin to ease the withdrawal symptoms when tapering off, i was always cautious not to take it for too long for the unknown unknowns.

In these studies it suggests patients were exceeding doses, but it doesn't mention by how much and it even mentioned route of administration might have played a factor, perhaps some nut was injecting this stuff.

Basically, im just curious if gabapentin can be used like baclofen e.g. you are prescribed 900mg of gabapentin a day to curb your cravings. can you stay on this dose indefinitely like baclofen or would you encounter problems with tolerance and withdrawal. even if this is true, i think baclofen is a better option given that the anecdotes online suggest that tolerance is an issue which you dont see in baclofen.

When ive used gabapentin i do experience a craving reduction, but it is not as pronounced as baclofen. The difference is that i do crave less but the euphoria from alcohol is still there but the desire to keep drinking goes away after a certain level of "drunkenness" was achieved. where if i was not taking gabapentin that threshold would be higher.

[Ne/Neva Eva]

I have had mixed results with gabapentin, but know of quite a few people for whom it has worked. It will be interesting to see what happens.

[neophyte]

It must need more research on long term use, ive heard enough anecdotes that suggests its dependence is worse than benzos, months of withdrawals. so im always cautious when I use it, not to use it for too long etc.

[Greg]

Many of these drugs developed initially for epilepsy and certain forms of pain have not been around for anywhere near as long as the benzos have, so we may know less about their withdrawal problems. Personally I don't have the experience to say whether pregabalin and gabapentin cause worse withdrawals than benzos, but if these drugs can help with alcoholism and alcohol cravings then I'd say they're worth considering if someone can't get free of alcohol by other methods. After all, alcohol physically and mentally destroys alcoholics who don't/can't stop drinking.