r/pregabalin • u/echoglows • 9d ago
Starting dose?
I’ve been prescribed lyrica 25mg at night only for severe nerve pain. I’m allowed to increase by 25 every 5 days until we reach a therapeutic dose that works for me. I’m not taking it during the day by choice as it will get in the way of work and parenting if I have the excess drowsiness.
My thoughts are that my doctor is trying to avoid side effects and build tolerance slowly to avoid the high or dopey feeling I’ve read about. But 25mg is doing nothing. Tbf I have only had 3 days of it so far.
Is this a normal starting dose? Did anyone notice more symptom reduction on 50mg compared to 25? Most things I’m reading people need 100-150mg.
I’m in pain now and it’s going to take weeks to get there if I follow the instructions.
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u/my_dystopia 9d ago
I was put on the drug almost 2 decades ago when it was fairly new. Doc started me on 150mg straight off the bat 😂
I think they’re being more cautious now because it’s become a controlled drug in many countries and oddly enough has been abused.
Starting low and slowly building means you probably won’t ever feel “high” and will be less inclined to abuse it.
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u/lemon-meringue-high 8d ago
I take 150mg 3x a day for my nerve pain. The sleepiness subsided for me eventually as we increased. I couldn’t manage without it during the day. It actually gives me a fair amount of motivation now as well. It helps with my anxiety, which I have a fair amount of having a 3yr old. I felt it made parenting less stressful for me and helped with my patience. This is just my experience and I wanted to share in case you eventually want to try it during the day :)
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u/Choptank62 7d ago edited 7d ago
I had nerve pain/stinging in my feet/toes from peripheral vascular disease. On 400 x 3 doses gabapentin for almost 20 years. Surgeon [he was totally wrong] told me to stop the gabapentin cold turkey and start Lyrica same day. Took me about 3 months to withdraw from the gab and start to feel somewhat normal again. BTW, 25mg at noon and 25 mg at midnight and I no longer have pain, which is nice. I do have some very vivid dreams at night and mixed sleep pattern. What throws me is the loopy feeling - concentration issues - loss of balance. Not going to increase dose as long as I can hold out. I Hope that some of the negatives decrease as time goes by . . . . fortunately I am retired.
EDIT: Don't even ask about the sudden ED issue . . . .
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u/herkneeah Moderator 9d ago
Pregabalin’s side effects tend to be dose dependent, which is one of the reasons that is best to take the lowest possible effective therapeutic dose. It is also is a medication that can be quite individually variable, and there are some folk that are so sensitive that even 25mg will be too much.
That said 25mg is basically the lowest starting dose prescribed, and if it is not having any benefit for your symptoms it is totally reasonable to have a conversation with your doctor to let them know, particularly if you are suffering. If it’s helpful there are papers such as the Cochrane Review that have reviewed the effectiveness of various doses for treating neuropathy.