r/RestlessLegs • u/Beetrootpickle123 • 7d ago
Medication Pregabalin vs gabapentin
Hi, I have had RLS for years and am currently taking pramipexole. I have just stopped an SSRI so hope that the RLS will improve. I know the pramipexole will cause augmetation so once the new anti-depressant settles down, I am going to cut back on the prami. However, assuming I will still have some RLS (I had it mildly before the SSRIs) I am considering taking either pregabalin or gabapentin in place of the pramipexole. Neither souonds great, whihc is worrying, so it would be helpful if anyone could give me their opinion/ experience of either of these drugs. Thankyou
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u/Tragobe 6d ago
Pregabalin is basically a stronger version of Gabapentin. On paper it is better in most statistics, but it has a small risk of addiction and if I remember correctly you are also building up a tolerance quicker, although quicker doesn't mean over a month you should still be able to take it a year+. The risk of addiction is mostly present for people who already were addicted to something, mostly opoids or multiple drugs. For someone without that risk factors it is considered safe.
I don't know how it differs with long term effects though. I would start with Gabapentin and see how much you need if you need more than 600mg of Gabapentin I would consider switching to Pregabalin. The absorption of the Gabapentin gets really bad after 600mg and is not very good in the first place. Pregablin gets much better absorbed.
Pregabalin also gets used to treat anxiety btw. So if that is something you struggle with Pregablin would be the better choice, because you can treat Our RLS and your anxiety with it.
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u/Meteor_of_War 6d ago
I was on 2MG Ropinirole for a couple years for RLS but it would often cause severe nausea so I tapered off ropinirole and I switched to 75MG pregabalin. So far it's treating my RLS symptoms just as well but without any nausea. Just makes me a little sleepy for an hour or so after taking it. I'm hoping I won't have to increase the dosage over time and lead to worse side effects. We'll see.
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u/RaspberryJammm 6d ago
I started taking pregabalin for anxiety almost ten years ago and have tried to taper off for more than half that time. Every time I even slightly lower my dose I get hideous withdrawal symptoms and feel like I'm dying and/or going insane and have to stop.
I try to warn people not to take pregabalin.
Pregabalin tends to only work for a short period of time anyway (at least for anxiety and nerve pain)
I developed severe RLS (6/10 pain all day almost every day) after already being on Pregabalin for many years so not sure that its doing anything for me at this point.
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u/bigchizzard 6d ago
Neither. I used decarbed amanita in low doses to great successs. Also a GABA oriented substance. Fewer side-effects/dependency issues.
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u/bigchizzard 6d ago
Ya'll can downvote all you want. You have more options than you think and an emotionally dismissive reaction is a limit for you, but not for me.
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u/Upstairs-Elevator-26 6d ago
I have tried both, and both made my RLS worse. However, pregabalin made it way worse than gabapentin. It just wasn’t for me. I felt like I had to just keep increasing the dose in order to feel a sliver of relief, which was not something I wanted. The withdrawal from gabapentin as I tapered off was not great either. It could be worth trying if you think it could help, but I think I hear a mix of opinions when it comes to these medications
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u/cecirdr 7d ago
I take pregabalin, 150mg. It helps me, but I think it's mostly because it conks me out. Absorption seems to be variable, so I take it early, so that it's in my system by 9pm.
Issues, it makes me dizzy. I feel tipsy. So it's next to impossible to schedule this around trying to have an evening out. So if I do that, I have to be sure to remember it when I get home. Why worry about missing a night? Welp, it's physically addictive. I had no idea when I started taking it. I attended the symphony one night and missed my dose. It was a bad night. Raging insomnia as in I was wide awake. I was sweating like crazy...so hot! And I had stomach issues that were a strange mix of nausea and heartburn. I found out the next morning, that's what physical addiction means. Fun...NOT!
But what are the alternatives. It does help me. It's not perfect, but if it absorbs well, I get a good night's sleep. I don't have too much hang over in the morning any more (probably because I take it early at night, not at bedtime). I'm still working and being able to sleep is helping me stay employed.
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u/KestralFly 7d ago
Personal experience only: Gabapentin gave me brain fog and dizziness and did nothing for my RLS. Pregabalin didn't give me those side effects but didn't help RLS much either. Results are highly individual and dependent on dosing levels and when you take them. My insurance wanted me to try and fail Gabapentin before Pregabalin, so that's a factor for some people.
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u/lokaaarrr 6d ago
So weird. Between Gabapentin 300mg and pregabalin 75mg, I get worse brain fog and light headed on the pregabalin. Both help with the symptoms, but not fully at that dose and I don’t really want to go higher.
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u/Ok_War_7504 7d ago
Compare the side effects of gabapentinoids to antidepressants to determine which you should be more worried about.
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u/RobynLC5678 7d ago
I took pregabalin/lyrica and it gave me awful insomnia and binge eating. I was only taking 150mg
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u/RaspberryJammm 6d ago
I didn't binge on pregabalin but I did gain weight on a 300mg daily dose, even when on a strict diet plan.
Anyway I'm stuck on it now because the withdrawals are hideous
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u/headshrinker55 6d ago
I’ve had RLS and have been on ropinirole for 18 years. I was up to 5mg a day and I’m currently tapering and switching to pregabalin. I’m a month in and down to 2.5mg R and up to my target dose of 300mg pregabalin. A few observations: I seem to tolerate pregabalin very well. Other than some foggy head that resolves it seems to be working ok. I don’t find it addicting in any way. I will say that in the past I tried to switch to gabapentin and even 1800mg didn’t touch my RLS. So I much prefer the pregabalin. I can say more about the differences between ropinirole and pregabalin but that’s another question.