What is the difference between pregabalin and gabapentin

The random-effects method and the fixed-effect method were used for studies with significant heterogeneity and for those without heterogeneity, respectively. The processes of literature search, removal of duplicates, and screening based on title, abstract, and full text is shown in Fig.

The articles found in the initial search were narrowed down to 8 articles that were selected for further eligibility assessment. After checking for all inclusion and exclusion criteria, finally, eight articles [ 39 — 46 ] were included in this review.

One head-to-head trial was excluded due to the fact that the type of disease was not specified [ 47 ]. In both studies [ 45 , 46 ], pain scores were measured by the visual analogue scale VAS. Sleep quality, depression, and anxiety were secondary outcomes. Pain scores were measured by the VAS and duration-adjusted average change.

The nine-item medical outcomes study-sleep scale problems index and the hospital anxiety and depression scale were used to measure sleep quality, depression, and anxiety, respectively. In three other RCTs, GBP was compared with a placebo [ 39 , 40 , 42 ] and an active placebo diphenhydramine in patients. The VAS, numeric rating scale, and neuropathic pain scale were used to measure pain scores.

In one study, depressive symptomatology was measured by the center for epidemiologic studies depression scale short form. Study characteristics are presented in Table 1 [ 39 — 46 ]. PGB vs. There was no significant difference between two drugs for reducing pain. SD: standard deviation, CI: confidence interval, df: degree of freedom. PGB is effective vs. PBO for all outcomes.

GBP vs. In one study [ 42 ], there was no significant difference between GBP and an active placebo diphenhydramine in terms of pain scores. Generally, GBP vs. There was no significant difference between two drugs for AEs. CI: confidence interval, df: degree of freedom. Nonetheless, one of the selected studies showed no significant difference in AEs between the recipients of GBP and the placebo [ 39 , 40 , 42 ].

The incidence of dizziness was higher for PGB. This study is the first systematic review and meta-analysis in which the two drugs have been compared directly with each other. A systematic review of head-to-head trails provides the highest quality evidence to compare the effectiveness of the two interventions [ 48 ]. In recent years, several recommendations have been published considering the efficacy and safety of PGB and GBP in the management of neuropathic pain after SCI [ 17 , 19 , 32 — 36 , 49 ].

To our knowledge, these recommendations [ 17 , 19 , 32 — 36 , 49 ] were limited to randomized placebo-controlled trials only and, due to the lack of head-to-head studies, had important limitations. Recently, A limited number of studies performed head-to-head comparison of these drugs and the results of these studies showed that both drugs were effective in the treatment of neuropathic pain [ 45 , 46 ]. The results of our meta-analysis showed that both PGB and GBP have similar efficacy in reducing pain, and there was no significant difference between the two interventions.

In previous systematic reviews [ 17 , 19 , 32 — 36 , 49 ], both drugs were found to be effective in reducing neuropathic pain due to SCI, which is similar to the findings of the present study.

In several systematic reviews [ 17 , 35 , 36 ], no significant difference was reported between the efficacy of PGB and GBP in individuals with SCI, which, from the statistical point of view, is similar to the findings of our study. On the other hand, evidence shows that results of indirect comparisons are usually in accordance with the results of direct comparisons [ 53 ].

The findings of the current study vary from several other review studies [ 32 — 34 ] which compared PGB and GBP with a placebo. These differences can be attributed to the lack of head-to-head trials in those studies. In a meta-analysis conducted by Mehta et al. Ghosh et al. The findings of this meta-analysis showed that PGB, compared to a placebo, was more effective in reducing neuropathic pain, sleep disorders, anxiety, and depression, while, GBP vs.

Our meta-analysis showed that dizziness was a side effect of PGB in comparison with a placebo. However, the results of a study [ 54 ] showed the long-term safety and tolerability of PGB in patients with central neuropathic pain due to SCI. Results of a systematic review by Tzellos et al. The poor methodological quality of the head-to-head studies, small sample sizes, and lack of enough data limited our ability to perform further in-depth meta-analysis on findings of the previous studies.

Restriction of the reviewed studies to the English language was another limitation of this study. However, expanding the inclusion criteria to the studies with English abstracts increased the pool of the potential studies to be chosen for further analyses.

Likewise, head-to-head studies showed that there was no significant difference between the two drugs in reducing pain scores.

Similarly, there was no significant difference in the safety profiles of the two drugs. We suggest a network meta-analysis for future studies. No potential conflict of interest relevant to this article was reported. National Center for Biotechnology Information , U. Journal List Korean J Pain v. Korean J Pain.

Published online Jan 1. Author information Article notes Copyright and License information Disclaimer. Corresponding author. This article has been cited by other articles in PMC. Study selection After removing duplicate records, two authors ABa and ABe independently reviewed the titles and abstracts of the articles that were included based on the inclusion criteria. Data analysis A meta-analysis was performed to compare the efficacy and safety of PGB vs. Literature search The processes of literature search, removal of duplicates, and screening based on title, abstract, and full text is shown in Fig.

Open in a separate window. Table 1 Characteristics of the Included Studies. Efficacy outcomes PGB vs. There is no established guidance on converting between gabapentin and pregabalin. Discontinuation symptoms reported include insomnia, nausea, anxiety, pain, and sweating. If analgesic effect is suboptimal 1—2 weeks after completing the switch, pregabalin can be titrated up at seven-day intervals to a maximum daily dose of mg bd.

As expected, pregabalin doses at the higher end of the dose range are more conservative than other published algorithms. The adverse consequences of giving too much pregabalin when switching from gabapentin are an increase in the intensity of side effects.

Many patients are reluctant to continue a medicine if they have unpleasant side effects when starting treatment. Treatment choices in neuropathic pain are limited, so losing an option due to potentially avoidable side effects can be frustrating. Ifuku et al8 reported a significant increase in the number of patients with peripheral oedema after switching from gabapentin to pregabalin.

We are now recommending a lower starting dose of 75mg at night, or 25—50mg in people who may be susceptible to adverse effects, eg, adults over 75 years old. Press enter to search. Latest Issue. Previous Issue. Clinical correspondence. Editorial Board. Vol No 8 March How much Lyrica and gabapentin cost depends on the treatment plan your doctor prescribes, your insurance plan, and your pharmacy.

You can find price estimates for these medications on GoodRx. Brand-name medications are often more expensive than generics. Talk with your doctor or pharmacist to learn about the generic form of either drug. Both Lyrica and gabapentin treat partial onset seizures and nerve pain that occurs after shingles. These drugs can cause some of the same side effects, as well as some different ones.

Some of these side effects are mentioned below. For more information about the side effects of the two drugs, see the Lyrica medication guide and the gabapentin drug label. The following lists address some of the most common side effects of each drug and some that both can cause. Most side effects of Lyrica and gabapentin are mild and go away after using either medication for a few weeks.

Be careful with any tasks that require concentration or focus, such as driving, until you become used to the effects of the medication. The following lists address the serious side effects of each drug and those that both drugs can cause. If you have serious side effects while using Lyrica or gabapentin, call your doctor immediately. Note: For more information about mild and serious side effects, see the side effect sections in the Lyrica and gabapentin articles.

There are few studies directly comparing how well Lyrica and gabapentin work. But studies show that both Lyrica and gabapentin are effective for treating partial onset seizures and nerve pain that occurs after shingles.

According to guidelines , Lyrica and gabapentin are recommended for treating partial onset seizures. Other guidelines recommend the two drugs as treatments for nerve pain that occurs after shingles. For information about how the drugs performed in clinical studies, see the Lyrica and gabapentin prescribing information. Lyrica and gabapentin may not be right for you if you have certain medical conditions or other factors that affect your health. Some are mentioned below. If any of the following medical conditions or other health factors are relevant to you, talk with your doctor before using Lyrica or gabapentin.

Note: For more comprehensive information about these two drugs, visit our Lyrica and gabapentin articles. Lyrica and gabapentin are used to treat some of the same conditions: partial onset seizures and nerve pain that occurs after shingles. The doctor can also explain the risks and benefits and advise about which may be right for you.

For more information about partial onset seizures, see our list of epilepsy articles. To learn more about nerve pain after shingles, see our list of shingles articles. Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date.

However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional.