Dizziness pregabalin

Pregabalin Dizziness Pedal edema Weight gain... 

Gabapentin, a non-benzodiazapine GABA analog, was modestly effective in a 14-week controlled trial in SAD. Most patients were titrated to a maximal dose of 3600 mg/day.58 Pregabalin 600 mg/day was effective for social anxiety, fear, and avoidance behavior in a 10-week controlled trial.63 Pregabalin was well tolerated, and the most common side effects were somnolence and dizziness. 

Pregabalin produced anxiolytic effects similar to lorazepam, alprazolam, and venlafaxine in acute trials. Sedation and dizziness were the most common adverse effects, and the dose should be tapered over 1 week upon discontinuation. 

Most common adverse reactions in all controlled clinical studies Blurred vision, dizziness, dry mouth, edema, somnolence, thinking abnormal (primarily difficulty with concentration/attention), and weight gain were more commonly reported by subjects treated with pregabalin. 

Gabapentin acts by increasing GABA activity, although its exact mechanism of action is unclear. It causes dose-related sedation and dizziness. It has been shown in randomised controlled trials to be effective in social anxiety disorder (Pande et al. 1999) and to benefit some patients with panic disorder (Pande et al. 2000). Pregabalin is a related compovmd that has recently demonstrated efficacy in GAD in a phase III study (Pande et al. 2003). 

Pregabalin As for gabapentin Well absorbed orally not bound to plasma proteins not metabolized ti/2 6—7 h Partial seizures Toxicity Somnolence, dizziness, ataxia Interactions Minimal... 

Pregabalin is another second-generation anticonvulsant that has recently obtained FDA approval for treatment of neurogenic pain, and several randomized placebo controlled studies have shown that this compound is efficacious in the treatment of painful diabetic neuropathy [32]. Doses between 300 and 600 mg/day have shown effect already apparent after 1 week of treatment. There are few clinically important drug interactions as there is no interference with the cytochrome 450 system. This compound requires minimal dose titration and seems easy to use. Side effects to gabapentin and pregabalin include drowsiness, dizziness and peripheral edema. 

Observational studies Pregabalin has been evaluated in an open 21-week study in 476 adults (mean age 40 years) with partial seizures inadequately controlled with one to three antiepileptic drugs 7% discontinued for lack of efficacy and 12% because of adverse events [247 ]. The three most common adverse reactions were dizziness (17%), somnolence (13%), and weight gain (13%). 

Systematic reviews In a meta-analysis of pregabalin trials in patients with fibromyalgia, four high-quahty randomized trials were included [257 ]. Only a minority of patients achieved moderate or substantial pain rehef. The proportions of patients with any adverse event, somnolence or dizziness, were significantly greater with pregabalin than with placebo. There was no difference with regard to serious adverse events. 

The most frequent adverse effects of pregabalin are dizziness and drowsiness other common effects 3QQ include visual disturbances, ataxia, dysarthria, tremor, lethargy, memory impairment, euphoria, constipa-... 

Dizziness, which may occur in up to 31% of pregabalin treated patients. Hence, caution with driving should be taken. 

Pregabalin and celecoxib, alone and in combination, have been evaluated in the treatment of chronic low-back pain in 36 patients in a 12-week, randomized, crossover study [267 ]. The combination was more effective than either monotherapy. Adverse effects were recorded in 16 patients and four patients withdrew as a result. Five patients reported nausea or dizziness during treatment with pregabalin and seven had similar symptoms during treatment with celecoxib -I- pregabalin. 

Of 20 patients with essential tremor who were randomized to pregabalin 150-600 mg/day or placebo in a double-blind, crossover study four withdrew during pregabalin treatment because of postural instability, nausea, and dizziness (two cases) [269 ]. Other adverse effects were mild to moderate in intensity. More common during pregabalin versus placebo were drowsiness (pregabalin 5 versus placebo 3), dizziness (4 versus 1), and fatigue (3 versus 0). 

Tramadol 100 mg/day has been compared with ibuprofen and pregabalin in 20 healthy volunteers [173 ]. Tramadol was associated with mild adverse effects, mainly fatigue/drowsiness (eight episodes), nausea/ vomiting (seven), dizziness/headache/dijfi-culty in concentrating (seven). The NNTh for tramadol was 1.6. 

Placebo-controlled studies In a placebo-controlled study of pregabalin 150 mg/day for treatment of pain related to abdominal adhesions [138 ], 2 of 11 patients receiving pregabalin reported dizziness night sweats, headaches, hyperactivity, drowsiness, blurry vision, and hand numbness were each reported once. One patient intentionally overdosed on pregabalin in a failed suicide attempt. The medical complications caused by this overdose were not specified. 

Observational studies An open label study of pregabalin for refractory seizures in 136 Mexican patients found that the most common adverse events were somnolence (39.7%), dizziness (16.2%), and weight gain (14%) [139 -]. 

Of the 20 patients receiving pregabalin for depression, eight reported concentration difficulties, seven reported somnolence, six reported headache, six reported dry mouth, five reported diarrhea, four reported dizziness, and three each reported blurred vision, weight gain, and edema [llO ]. 

Of 25 patients receiving pregabalin as add-on therapy in tumor-related epilepsy, only two reported adverse events one reported dizziness and one reported dr5mess of the eyes. Both of these patients dropped out of the study [141 ]. 

Systematic reviews A meta-analysis of pregabalin use in generalized anxiety disorder found that the most adverse effects reported were somnolence, dizziness, headache, and dry mouth [142 ]. 

A meta-analysis of pregabalin safety in Japan as compared to Western coxmtries [143 ] found that dizziness and somnolence were the most common adverse effects, and that they tended to occur early in the course of pregabalin treatment and later resolved. A slightly higher incidence of dizziness and somnolence was reported in Japanese studies as compared to those from Western nations. The authors speculated that this may be related to the lower mean body weight in the Japanese population leading to a higher mg/kg dose. 

---