Pregabalin | Medication For Anxiety

Medication name

Pregabalin ("Preh-GA-ba-lin")
Brand names

Alzain™ ("Al-zain")

Axalid (“Ax-a-lid”)

Lyrica™ ("LI-ri-ka")
Medication type

Anxiolytic

Anticonvulsant

Capsules: 25mg, 50mg, 75mg, 100mg, 150mg, 200mg, 225mg and 300mg

Liquids: 20mg pregabalin in 1ml of medicine (sugar-free)

If you are 18 or over, the doctor can prescribe pregabalin for you as a licensed medicine for generalised anxiety disorder (GAD).

If you are under 18, a specialist doctor may still consider this as a treatment option for other conditions such as anxiety or depression.

Read our guide to anxiety

About pregabalin

Pregabalin is an anxiolytic medication. This means it is used to treat anxiety.

It works by stopping your brain from releasing the chemicals that make you feel anxious. It is related to the calming brain chemical gamma aminobutyric acid (GABA).

It works in different ways for nerve pain and epilepsy.

Pregabalin is a ‘controlled drug’

This is because there is an increased risk of the medicine being supplied or sold illegally and misused.

Sometimes people taking pregabalin from their doctor may be targeted at school and bullied to give away or sell their medicine.

If someone is asking you to give away or sell your medicine, please ask your parent, teacher or doctor to help you. Never share (or sell) your medicine to anyone else. This is dangerous and illegal.

If you must take it to school, check with your teachers how to keep your medicine safe until you need it.

There are special rules and laws for how controlled drugs are prescribed.

The doctor must write extra information on the prescription, like the total amount needed in words and figures to make it harder for a genuine prescription to be altered.
A prescription for pregabalin must be dispensed by the pharmacy and collected within 28 days of the prescription being written. Other prescriptions for medication that isn’t a controlled drug are valid for up to six months.
You cannot get an emergency supply of pregabalin without a prescription.

Pregabalin and everyday life

It can take a little time for pregabalin to start helping with anxiety. In most clinical trials, researchers saw people getting relief from the symptoms of anxiety by week four of taking pregabalin.

Many people take pregabalin for some months to prevent their symptoms from returning.

You and your doctor should discuss how long you need to take pregabalin.

A side effect of pregabalin may be increased appetite and weight gain.

It is not possible to predict how pregabalin will affect each person before they start taking it. Talk to your doctor or pharmacist if you are concerned about your weight, or changes to your weight, while taking pregabalin.

Young people with diabetes who put weight on during treatment may need to change their diabetes medicine dose. See your doctor if this applies to you.

A very common side effect of pregabalin is a dry mouth. Over a long time, this can increase your risk of developing tooth decay or gum disease. Make sure you brush your teeth well and have regular dental check-ups. Speak to your dentist, doctor or pharmacist about things you can do to help.

You may want to let your family and friends know you are taking pregabalin so they can support you and help you look out for side effects.

For guidance on this, check out our page on getting support with your medication.

You can feel drowsy in the first few days of taking pregabalin. This should get better after the first week or two.

Some people find that pregabalin causes insomnia (difficulty getting to sleep), and disturbing dreams or nightmares.

If you have been taking pregabalin for more than a month and you continue to feel very tired, sleepy or struggle to function during the day, you should go back to your doctor and discuss what changes could be made to help. This may include switching to a different medication.

Alcohol

It is recommended that you avoid drinking alcohol if you are taking pregabalin. You may occasionally be able to drink a small amount of alcohol but having the two together might make you very sleepy and unsteady on your feet. It could also make your breathing worse, so you need to be very careful.

During the first few weeks of treatment, you should stop drinking alcohol until you see how the medicine affects you.

Drinking alcohol every day, or in large amounts, can make your symptoms worse and may mean you won’t get the maximum benefit from your medication.

Street drugs

Pregabalin may increase the effects of ‘depressants’ like benzodiazepines or opioids. The combination can lead to respiratory depression and failure, where your body doesn’t get enough oxygen. This is a very serious condition and if not treated quickly can be life-threatening.

We do not know how pregabalin mixes with street drugs but it will probably make the drowsy effect of any other drug worse, so it’s best to be cautious.

There is no regulation of street drugs or ‘legal highs’, so even if there are no known issues with the medication you take, the supply you receive might be mixed with other substances that could be dangerous.

Pregabalin can also be misused. Do not pass on your medicines to anyone else.

Get more advice on our drugs and alcohol guide.

Always check with your doctor or pharmacist before taking other medicines with pregabalin, including herbal medicines. Taking pregabalin together with other medicines can increase the side effects you might get (especially feeling tired) and this could be dangerous.

Before you start taking pregabalin, tell your doctor if you are taking any other medications including things you have bought from a pharmacy (or other shop) for common illnesses like colds and flu. This includes things that you put on your skin.

Always tell the pharmacist that you are taking pregabalin if you buy any medicines from a pharmacy.

Look at the leaflet inside your medicine box for more information about other medicines that can interact with pregabalin. With some medicines your doctor may need to adjust the dose of your medicines if you take them together. Ask a doctor or pharmacist for more information if you have any questions.

There are multiple companies that manufacture this medicine and the non-active ingredients may vary between products and also between the different strengths of tablets that are available.

Pregabalin oral solution contains a small amount of alcohol, but not enough to affect your blood alcohol level.

The oral solution also contains parahydroxybenzoates which may cause allergic reactions.

Always let your pharmacist know if you have any food allergies or intolerances, and always check with them if you’re concerned about any of the ingredients in your medication.

If you need to avoid animal products, please note that non-active ingredients used in the production of medicines may sometimes be of animal origin and that pregabalin capsules contain gelatine. Ask your pharmacist if you have any questions about the ingredients.

Further information about practical considerations for medicines if you need to avoid animal products can be found on the Vegan Society website.

Taking pregabalin may make you feel tired or dizzy and may affect your eyesight and balance when you start taking it.

This could affect you if you drive a car, ride a bike, or do anything else that needs a lot of focus or good balance. It might be best to stop doing these things for the first few days, until you know how it affects you.

Most people drive as normal while taking pregabalin. If you are worried about this or have any concerns you would like to discuss, speak to your doctor or pharmacist.

Pregnancy

Some studies show that there is a slight increased chance of physical birth defects when pregabalin is taken in early pregnancy, but more research is needed to understand this. You are advised to use effective contraception while you are taking pregabalin.

If you become pregnant while you are on pregabalin, you should carry on taking it and make an appointment to see your doctor as soon as possible They can discuss the benefits and risks of continuing pregabalin and help you to make a decision that is best for you and your baby.

They may refer you to a specialist perinatal mental health team to support you with this decision.

You can find out more information about taking pregabalin during pregnancy at Bumps (Best Use of Medicines in Pregnancy).

Untreated anxiety can also be harmful to you and your developing baby, so decisions about stopping or avoiding medication when you are pregnant need to be discussed carefully with your doctor. If you and your doctor agree that it is best for you to continue taking pregabalin while pregnant, tell your midwife. If you are planning to get pregnant, it is recommended that you take folic acid while you are trying for a baby and during pregnancy. It is safe to take this together with pregabalin.

Post-natal

Some newborn babies whose mothers take pregabalin during pregnancy can get symptoms at birth and soon after, like restlessness or feeding difficulties.

Tell your midwife if you are taking pregabalin, so that they can help if the baby has any symptoms at birth.

Breastfeeding

Pregabalin is passed to the baby in breastmilk in small amounts.

If your baby was born early, then breastfeeding while you are taking pregabalin may not be recommended. Talk to your midwife and doctor about feeding options.

If you do breastfeed while taking pregabalin, seek urgent medical advice if your baby becomes restless, very sleepy or develops feeding problems.

Sex

Pregabalin can have side effects that might affect your sex life. These include:

Lower sex drive
difficulty getting an erection
changes in periods, either being heavy and painful or stopping altogether
breast pain or slight breast growth, regardless of gender

Untreated depression or anxiety can have a negative effect on your sex life, so if pregabalin helps you to recover, positive effects can include improving your desire, experience and enjoyment of sex as your mood lifts and you become interested in life and relationships again.

Fertility

There is no evidence to suggest that pregabalin will affect your fertility. Talk to your doctor about your pregabalin if you are trying to get pregnant or planning a family.

Pregabalin is not a banned substance in sport.

Most people play sports as normal while taking pregabalin, but if pregabalin affects your concentration, eyesight or co-ordination, then you may want to wait to see if those effects go away before playing sports that need a lot of focus. If you have any concerns, discuss this with your doctor.

Pregabalin may make you feel tired or dizzy, give you blurred eyesight or affect your memory.

Ideally it is best not to take pregabalin for the first time just before your exams.

It is not possible to predict how the medication will make you feel, and if you do get any side effects, these are more likely to occur when you first start taking pregabalin.

You should talk to your doctor about any future exams if you are starting pregabalin. You might decide together to delay starting it until you have done them.

If they are more than a month away, however, you might find that it is better to start pregabalin to improve your motivation and ability to study.

Most people take exams as normal while taking pregabalin but if you have any concerns, discuss this with your doctor.

Information and safety considerations

Your doctor will consider any other medical conditions or symptoms you have before recommending a medicine for you.

Your medicine will come with a ‘patient information leaflet’. It’s important that you read this information. Speak to your pharmacist if:

you’re not given a leaflet
you don’t understand the information
you need it in a different format or language
you’re concerned about something you’ve read

The information leaflet also includes a list of warnings and precautions to consider before you take the medicine. If you think that any of these apply to you and are concerned that your doctor is not already aware of them, check with your doctor or pharmacist before you start to take your medication (or as soon as possible if you are already taking it).

Uses, warnings, safety and side effects

Taking pregabalin

Your doctor will advise you about how long it is best to continue with your medication. This is likely to be at least several months but could be up to a year or longer.

You will get the best effects from your medicine if you take it every day at the dose prescribed by your doctor.

You may have to take it two or three times a day.

Your doctor may start you on a small dose, which they will then increase slowly over two to three weeks.

It does not matter what time you take it each day. Choose times that you can always remember. This could be at mealtimes or when you brush your teeth.

You can take it before or after food.

Swallow the capsule whole, with a drink of water – if you chew it, the taste of the ingredients will be unpleasant.

If you are using the oral solution, you will get a special syringe and stopper with the bottle when your medicine is dispensed so you can measure your exact dose.

If you remember, take it as soon as possible.

If you forget to take it by the time your next dose is due, just miss it out and start again with the next dose. Do not try and catch up by taking a double dose.

If you forget to take your medicine for a few days, you may start feeling anxious again, or you might experience other withdrawal symptoms. These should improve quickly after you start taking pregabalin again. If they do not, or if you are worried about your symptoms, seek advice from your doctor or pharmacist.

If you regularly forget to take it every day, your medicine may not work as well and it could increase the risk of you becoming unwell again.

Pregabalin is not usually addictive, but dependence on this medicine has been reported.

If you stop pregabalin, it is recommended it is done gradually over at least one week. Discuss this with your doctor and agree a plan to gradually reduce and stop your medicine together.

If you stop taking this medicine suddenly, you will probably get uncomfortable withdrawal symptoms. These symptoms can be worse if you are taking a high dose of pregabalin or have been taking it for a long time. This does not mean you are addicted to the medicine. It just means that your brain has become used to having it there.

Some of the symptoms you might get include:

dizziness or headaches
finding it hard to get to sleep
feeling anxious or nervous
feeling sick or getting diarrhoea (having loose poo)
sweating a lot
low mood (feeling depressed)
having thoughts of harming yourself or taking your own life
flu-like symptoms
feeling pain
having seizures or fits

Some of the symptoms you get may be like symptoms you had when you were unwell, so understandably, you might feel anxious or upset that your illness could be returning.

Go and speak to your doctor if you have missed a few doses or have decided to stop taking your medication. If you slowly reduce your medication, withdrawal symptoms are less likely to occur.

Warnings and safety

If you have taken more than the dose prescribed by your doctor, contact NHS 111 immediately to ask for advice, or ask a family member or friend to do this for you. This is important even if you don’t feel any different.

NHS 111 can give you advice and direct you to the best place to get more help if you need it.

If you have taken too much medication on purpose, or if after taking this you quickly feel unwell, call 999 or get someone to take you to A&E straight away. This includes any of the following signs:

feeling sleepy
confusion
agitation
restlessness

If you need to go to A&E, do not travel alone or drive yourself there. Get your parent, family member or friend to go with you to support you and keep you safe on the way. If someone is not able to drive you there, call for an ambulance. Take your medication with you and tell doctors how much you have taken.

Suicidal thoughts

Anxiety (and other mental illnesses) can sometimes cause you to have thoughts about hurting yourself or taking your own life. While uncommon, this could also be a side effect of your medicine. This can happen to anyone but is more likely to happen if you are under 25 years old.

If you have any thoughts like this, it is important you get urgent help. Contact your doctor immediately for advice and support. This could be your GP or specialist mental health team. If you are able, share how you are feeling with family member or friend as well so they can support you to get help.

If you discussed with your doctor what to do if you get these thoughts and created a safety plan, read this to remind you who to contact for support and what you can do to help you cope.

Read our guide to suicidal feelings

Serious side effects

Pregabalin can cause serious side effects, including allergic reactions.

Stop taking pregabalin and go to a hospital straight away if you get any of the following symptoms:

an allergic reaction or allergy (including symptoms such as swelling of your face, eyelids, lips, tongue or throat so that you cannot swallow or breathe or really bad itching of the skin with raised lumps)
you start having seizures or fits for the first time
any patches of skin rash, including red skin which starts to blister or peel off

Get your parent, family member or friend to take you or go with you to support you and keep you safe on the way. If someone is not able to drive you there, call for an ambulance. Take your medication with you.

Contact your doctor immediately but don't stop taking pregabalin, if you get any of the following symptoms:

problems with your eyesight (blurred vision or reduced sight)
your behaviour changes because you feel very happy or over-excited or experience severe irritability or agitation
yellowing of the skin or whites of the eyes (your liver may not be working properly)
if fits that you have had in the past happen more often

If you are unable to contact your doctor, call NHS 111 for urgent advice.

Side effects and your health

Side effects are more common when you first start taking pregabalin.

Many go away as you continue your medicine. If they don’t get better, or if you are worried by them and they are causing you distress, speak to your doctor or pharmacist about them.

Very common side effects from taking pregabalin (affecting more than one in ten people) include:

dizziness
feeling sleepy
headache

Common side effects of taking pregabalin (affecting up to one in ten people) include:

increased appetite
weight gain
feeling very happy
feeling confused or disorientated
less interest in having sex, and difficulty getting an erection
feeling irritable, odd (not like your normal self), clumsy and tired
difficulty paying attention to things
forgetting things
tremor (shaking)
speaking problems
feeling drunk or walking in a strange way
tingling or numb feelings
having trouble sleeping
blurred vision, double vision
vertigo (feeling like things around you are moving or spinning, when they are not)
problems with balance, which may lead to falls
dry mouth or sore throat
constipation (difficulty having a poo) and passing extra wind
feeling sick and being sick
having a bloated or swollen gut
swelling of the body, including fingers and toes
muscle cramps, joint pains, back pain, pain in arms and legs

There are other side effects that you can get when taking this medicine. We have only included the most common ones here.

This list of side effects can look scary. You may not experience any of them, but it’s important to be aware of them so you know what to do if they do happen.

Unless your side effects are very severe or distressing, try to continue taking your medication until you can talk to your doctor. Your doctor can make changes to your medication to help if needed.

Uncommon but important side effects to be aware of include thoughts of harming yourself, thinking about taking your own life or trying to take your own life. This may be a symptom of your illness, including depression, but may be a side effect of medication. If you experience these thoughts, contact your doctor to seek immediate support to keep you safe.

Your doctor will make sure you are monitored carefully for these side effects, and you should decide with your doctor what to do if you experience these feelings while taking pregabalin. It’s a good idea to write these plans down and keep them somewhere safe.

If you are taking pregabalin and have not talked about this with your doctor, go back to them and talk it through. You might also want to talk to your parents, family member or friend about it too.

There is no routine monitoring recommended before starting or while you are taking pregabalin, although your doctor may recommend specific tests, like a blood test, to help them make decisions about your medication.