Pregabalin is useful in adding to other treatments when partial seizures cannot be controlled by other treatments. Used alone, it is not as effective as some other epilepsy drugs. It’s not clear how it compares to this use of gabapentin.
Pregabaline is recommended by the European Federation of Neurological Societies as a first-line treatment for pain associated with diabetic neuropathy, postherpetic neuralgia, and central neuropathic pain. A few people get substantial benefits and more people get medium benefits. It weighs the same as gabapentin and tricyclic antidepressants as first-line drugs, but the latter were cheaper in 2010. The evidence does not support its usefulness for sciatica or low back pain.
The use of pregabalin in cancer-related neuropathic pain is controversial. Although it’s quite common. There was no evidence that it could be used to prevent migraines, and gabapentin was found to be useless. It has been examined for the prevention of chronic pain after surgery, but its utility for this purpose is controversial.
Pregabalin is not generally considered effective in treating acute pain. In trials examining the efficacy of pregabalin for acute postoperative pain, no effect on overall pain levels was observed, but people did require less morphine and had fewer opioid-related side effects. Several possible mechanisms for pain improvement have been discussed.
Pregabalin has moderate efficacy and can be safely used in the treatment of generalized anxiety disorder. The World Federation of Biological Psychiatry recommends pregabalin as one of several first-line treatments for gAD, but others such as SSRIs as first-line treatments for obsessive-compulsive disorder and post-traumatic stress disorder. It appears to have similar anti-anxiety effects to benzodiazepines, but with less risk of dependence.
The effect of pregabalin appeared after one week of use and was similar to lorazepam, alprazolam, and venlafaxine, but pregabalin showed superiority by producing more consistent treatment for psychosomatic anxiety symptoms. Long-term trials have shown that it is consistently effective without tolerance and, unlike benzodiazepines, is beneficial for sleep and sleep structure, characterized by enhanced slow-wave sleep. Compared with benzodiazepines, it produces mild cognitive and psychomotor disorders.
A 2019 review found that pregabalin reduced symptoms and was generally well tolerated.
There is little evidence of benefit and significant risk for patients with chronic low back pain. As of 2016, evidence of the benefits of alcohol and certain other drug abstinence is limited.