New member - Pregabalin

Kathy Joh

Hi I am sort of new here - infrequent  I guess.  My elderly mom  is a dementia sufferer(mixed dementia) and we are managing her care between family and caregiving support.

She's been exhibiting aggressive behavior on a more regular basis and our doctor recommended an additional medication, pregabalin, which we know little about. It's primarily used for people with epilepsy. He explained a bit about it and I was going to call the pharmacist to find out the details, but was wondering if anyone here has had any experience with this drug being used for your LO. Thanks

M1

Hi KAthy, pregabalin is better known by its brand name, Lyrica. While it is technically an anticonvulsant, its most common use in this country is probably for nerve pain like neuropathy or fibromyalgia. Doses have to be gradually increased or decreased and it should never be stopped suddenly as it can cause a bad withdrawal syndrome. I'm not familiar with using it for dementia or aggression, but many of these drugs do have crossover uses. I'd have to ask questions in this setting and would encourage you to do the same.

M1

Kathy you got my curiosity going, so I looked this up this morning, found one article published in 2019 that was a small study.  The conclusion was the pregabalin or gabapentin (neurontin) could POSSIBLY be used for behavioral problems in dementia when other more established drugs were contraindicated or had been ineffective.  It was pretty weak.  I would definitely discuss other options with the doc and find out why they want to use this one specifically

mommyandme (m&m)

My mother takes Pregabalin (Lyrica) which started years before her Alzheimer’s diagnosis. She takes it for pain control. She cannot take Ibuprofen because they are on the same plain. Acetaminophen is alright though.  She’s also on Memantine and Galantamine for brain function and has been for at least a couple of years, probably closer to three.  Today she’s doing alright.

My understanding is Lyrica can be fairly potent and needs to be tapered up or down.  

Hope this info helps in some way.

Marta

Pregabalin is a controlled substance.  I would not have picked it first as an add on for aggressive behaviors in the setting of dementia.  Depakote, another med that was originally approved for epilepsy but is also used for behavioral disturbances, would have been my first choice.  It requires monitoring of liver function tests. 

You don't say whether your loved one is on any other medications for mood/behaviors.  Celexa, anSSRI .is an excellent first choice for dementia patients - i.e.  I would prescribe Celexa before adding anything else, like Depakote.

hanging_in

Hi Kathy,  My father was prescribed Lyrica to help with sleep issues and anxiety. He's had issues tolerating various other medications and his geriatric psychiatrist gave us two options, Zoloft (sertraline) being the second one.  We decided to go with Lyrica and he is doing well on it.  He sleeps soundly most nights compared to pre-Lyrica where he would sleep for an average of 4 hours and then be up completely stressed and agitated (for example, he thought someone was trying to kill him, there were intruders in the house, he needed to know his family was safe, there were snakes everywhere, etc.) and unable to get back to sleep.  There were some nights where he didn't sleep at all.  I would say Lyrica has been extremely helpful for him to give him a good night's rest, allow my mom (his primary caregiver) to recharge, and to reduce overall stress.