Lyrica vs. Gabapentin: Dosage, Effects and Withdrawal

Gabapentin and Lyrica (pregabalin) are two common drugs prescribed to treat several different medical conditions, including nerve pain. In 2019 alone, more than 47 million gabapentin prescriptions and more than nine million pregabalin prescriptions were filled in the U.S. But for all the similarities between the drugs, you should know some key differences if you take one of these medications.

Is Lyrica the Same as Gabapentin?

Lyrica (the brand name for pregabalin) and Neurontin (one of the brand names for gabapentin) are two different drugs that likely work similarly. Experts are not sure how either drug achieves its effects, but they are both known to work on calcium channels in the brain. Although structurally similar to — and named after — the neurotransmitter gamma-aminobutyric acid (GABA), they do not impact GABA in the brain or work on GABA receptors.

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What Are Lyrica and Gabapentin Used For?

Gabapentin and pregabalin are used to treat many similar conditions, including:

• Diabetic nerve pain
• Nerve pain from a shingles infection
• Nerve pain from a spinal cord injury
• Seizures

In addition, pregabalin can be prescribed to treat fibromyalgia, while gabapentin is sometimes prescribed for restless legs syndrome and hot flashes in menopausal women. They may also be prescribed for other conditions as directed by your doctor.

Differences Between Lyrica and Gabapentin

Despite being similar drugs believed to work in similar ways, pregabalin and gabapentin have some differences. These include differences in their side effects, doses and effectiveness in treating several different medical conditions.

Lyrica vs. Gabapentin Side Effects

Pregabalin and gabapentin share many common side effects because they are both central nervous system depressants that likely act in similar ways on the brain.

Common pregabalin side effects include:

• Dizziness
• Sleepiness
• Dry mouth
• Swelling
• Blurred vision
• Weight gain
• Attention and concentration problems

Similarly, gabapentin side effects include:

• Dizziness
• Sleepiness
• Movement difficulties
• Fatigue
• Swelling
• Rapid eye movements

Lyrica vs. Gabapentin Dosage

Pregabalin and gabapentin are both given by mouth in several different dosage forms and amounts. Both drugs rely on good kidney function to clear them from your system, so a person with poor kidney function may take lower doses of the drug. Pregabalin doses are lower than gabapentin doses because pregabalin is about six times more potent than gabapentin.

Pregabalin is usually taken twice daily, although the extended-release tablet is taken once daily. The drug is available in the following doses and dosage forms:

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

Oral Liquid: 20mg per milliliter

Extended-Release Tablets: 82.5mg, 165mg, 330mg

Gabapentin is usually taken two or three times daily and is best absorbed when taken with food. However, the extended-release tablet form of the drug may be given only once daily. It is available in the following doses and dosage forms:

Capsules: 100mg, 300mg, 400mg

Oral Liquid: 250mg per 5 milliliters

Tablets: 100mg, 300mg, 400mg, 600mg, 800mg

Extended-Release Tablets: 300mg, 600mg

Lyrica vs. Gabapentin Effectiveness

Pregabalin and gabapentin are both effective drugs for treating several different health conditions. Few studies have been conducted directly comparing the two drugs, and the studies that have been done have conflicting findings. For example, one study on spinal cord injury nerve pain found pregabalin was more effective than gabapentin and had fewer side effects. However, another study found no difference between the two treatments or side effects when used for spinal cord injury nerve pain. More studies would likely need to be conducted to get a clearer picture of whether one drug is better and safer than the other.

Lyrica vs. Gabapentin for Anxiety

Neither pregabalin nor gabapentin is the first-line treatment for anxiety, which is generally treated with a combination of antidepressants and therapy. However, in some cases, experts say pregabalin can be used at a total daily dose of 150 mg–600 mg. Gabapentin, on the other hand, is not a recommended therapy.

Lyrica vs. Gabapentin for Fibromyalgia

Pregabalin is one of the main treatments often used alongside non-drug therapies to treat fibromyalgia. It has been studied at a total daily dose of 450 mg to treat the condition. Although gabapentin has also been studied for fibromyalgia, its use is currently limited to research.

Lyrica vs. Gabapentin for Nerve Pain

Both pregabalin and gabapentin are commonly prescribed to treat several different causes of nerve pain, including post-shingles and diabetic nerve pain. Although several studies indicated that pregabalin might be more effective than gabapentin with fewer side effects when used for nerve pain, not all studies agree. One recent study found that gabapentin was more effective than pregabalin for nerve pain caused by sciatica and caused fewer side effects.

Lyrica vs. Gabapentin Withdrawal Symptoms

Because physical dependence can occur when pregabalin or gabapentin are taken regularly, the doses of both drugs should be lowered slowly instead of stopping cold turkey. Both drugs should be tapered over at least a week to avoid pregabalin and gabapentin withdrawal symptoms like:

• Trouble sleeping
• Nausea
• Headache
• Diarrhea
• Anxiety
• Sweating

Can You Take Lyrica and Gabapentin Together?

Most people should not take pregabalin and gabapentin at the same time. This is because pregabalin and gabapentin are believed to work similarly; therefore, they are duplicative, which increases the risk of side effects. If you take gabapentin and your doctor wants to switch you to pregabalin or vice versa, you will likely be instructed to stop taking one drug and change to the other.

However, there are exceptions. For example, if you have a history of seizures, your doctor may instruct you to slowly lower your dose of pregabalin and start taking gabapentin at the same time, increasing your dose over time. This type of dosing, called a cross-taper, slowly lowers one drug’s dose while gradually increasing the other dose. A cross-taper of pregabalin and gabapentin may be safest in people with a history of epilepsy or other seizures.

Lyrica and Gabapentin Abuse

Pregabalin and gabapentin vary in their potential for abuse, addiction and dependence. Pregabalin is a Schedule V controlled substance at the federal level, while gabapentin is not controlled. The difference in the drugs’ abuse potential is backed up by studies showing that pregabalin was more likely to be abused and misused. However, some individual states have made gabapentin a controlled substance at the state level, including:

• Alabama
• Kentucky
• Michigan
• North Dakota
• Tennessee
• Virginia
• West Virginia

Substance Abuse Treatment in South Florida

If you or a loved one struggles with gabapentin or pregabalin, you are not alone. It can be difficult to overcome prescription drug abuse on your own, but help is here. The Recovery Village at Baptist Health offers a full continuum of programs to get you off drugs and help you stay off for good. This includes a medical detox setting where you can be slowly weaned from prescription drugs while under around-the-clock care by doctors and nurses. Following detox, our rehab programs provide the tools you need to stay away from gabapentin and pregabalin for good. Don’t wait — contact us today to see how we can help.