Known for its properties to deal with epilepsy, anxiety, and nerve pain, Pregabalin is an anticonvulsant drug. It is a prescription drug, but recently there has been an increase in sales and consumption, as people have started to discover some of its more ‘recreational’ side effects. NHS Digital data shows pregabalin prescriptions to have risen drastically in the past few years, since 2006.  

The most common brand name given to the drug is ‘Lyrica’. People are said to get a somewhat euphoric high after using Lyrica. Some claim it to be the ‘new Valium’. Like all drugs, there are serious side effects and risks of overdose. Withdrawal symptoms of Lyrica can also be quite dangerous. In severe cases, side effects, overdose or withdrawal symptoms can all prove to be fatal.

Pregabalin is a medicine to treat and/or control anxiety and seizures. For this reason, it is anxiolytic and anticonvulsant. It is sold under the brand name Lyrica or Lyrica CR and is not sold as a generic drug – meaning that it is not produced under other brand names that use a particular active ingredient, it is a brand-name drug itself. It has the chemical composition of C8H17 N O2.

Pregabalin falls within the class of drugs known as gamma-aminobutyric acid analogs. Also called GABA analogs, these were invented to make administration of GABA more easily as intravenous or oral GABA has not been of much success. GABA is a naturally produced amino acid in our bodies that is responsible for balancing nerve inhibition and nerve excitation. Thus, GABA analogs are required for those individuals whose bodies are unable to control nerve firing efficiently – leading to nerve pain, seizures, restless leg syndrome, etc.  

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Pregabalin is a prescription drug and so it cannot be sold over the counter. This GABA analog is almost completely absorbed by the bloodstream, which speaks a lot about its speediness and effectiveness.  

 It is taken by the mouth, no matter its form. It can either be in the form of a solution, an extended-release (long-acting) tablet, or a pill. An oral capsule can be 25 mg to 225 mg, a solution is usually 20 mg per ml, and an extended-release tablet comes in dosages of 82.5 mg, 165 mg, and 330 mg. After being the cause of 33 deaths in Northern Ireland, Pregabalin was ranked as a Class C drug by the United Kingdom Misuse of Drugs Act in 2019 and has remained a Class C drug since. This means that it supposedly has the least potential for harm, if and only if it is taken as prescribed. 

Being an anticonvulsant, it works by slowing down the nerve impulses in the brain that cause seizures. This happens when the calcium channels in the brain (and all over the body) are inhibited by Pregabalin and electrical signals are disrupted from traveling elsewhere from the bran. This causes Pregabalin to ease neuropathic pain (that is, pain caused by nerve damage) by targeting chemicals in the brain that signal the pain to diminish. 

This nerve damage could be a result of diabetes, spinal cord injury, or herpes infection. It can also relieve pain in individuals who have fibromyalgia (in which the person has muscle stiffness and pain, lethargy, and trouble falling asleep). This is done by the drug slowing down brain activity and decreasing pain signals. It also increases the synthesis of the neurotransmitter GABA, which has anti-anxiety effects. Combining it with other medications can help control seizures, both in children and in adults. It is also used to treat Generalized Anxiety Disorder (GAD) and migraines. 

Before the doctor prescribes this medicine, he/she checks if the patient is free from any kidney or lung disease, low platelets and/or a bleeding disorder, depression, alcohol or drug addiction, heart problems, or diabetes. As mentioned earlier, it is a combination medicine and can be used with other medications. However, such illnesses are a cause for concern, and taking Pregabalin alongside these can exacerbate the symptoms greatly. Furthermore, it is not advised for children to take this without any professional medical assistance. For seizures, it should not be taken by children younger than 1-month-old, and for pain treatment, it should not be taken by those less than 18 years of age. It is also recommended to refrain from drinking alcohol while on this medication. If a dose is missed by accident, the patient should never take two doses at a time. Instead, he /she should continue as per schedule. 

The general practitioner also evaluates the types of medication the patient is already taking, as these can affect not only the absorption of Pregabalin but can also intensify its side effects. Sleeping pills, antidepressants, sedatives, tranquilizers, oral diabetic medication, antihistamines, anxiolytics, and even some vitamin and mineral supplements are an example of medications that can interfere with Pregabalin and/or worsen its side effects. 

Street names for Pregabalin 

The most popular trade name for Pregabalin is Lyrica, but it also has the following street names; “Budweiser” and “bud”. The reason behind these names is that one of the dosages comes in the form of a red and white 300 mg capsule, which has a similar “drunken” effect as alcohol does. “Fizers” is yet another street name for Pregabalin.  

Some trade names of the drug include Cobimep P, Gabafit, Alzain, Rewisca, Lecaent, Arena Tablet, Mecobion, and Nervo.  

 As narrated earlier, Pregabalin or Lyrica is not highly addictive as such. Dissimilar to other prescription drugs, like Vicodin, that can be dangerously addictive, Pregabalin does not pose this threat. But this does not mean that patients refrain from abusing it together. The user’s brain gets accustomed to the medication which results in physical dependence. Pregabalin abuse leaves the person feeling a sort of a “high” like that experienced when one drinks too much alcohol (corresponding to its street name Budweiser). 

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When used more than advised by the physician, and for much longer too, the patient becomes addicted – psychologically and physically. Dependence results as the brain want the same reward centers to get activated, which can only be activated when Pregabalin is ingested and absorbed by the bloodstream. Adding on, terminating the use of Pregabalin, after a prolonged period, will cause a series of withdrawal symptoms to occur. This is likely to make the patient resume taking the drug, despite no intention to do so. 

 Pregabalin abuse is becoming increasingly common in the United Kingdom, especially in Northern Ireland. In 2015, the drug was prescribed more than any other around the UK. A case was reported in which a 19-year-old died due to consuming a cocktail that contained Pregabalin amongst other drugs. It is a Class C drug and cannot be given without prescription, Lyrica had become a recreational drug in 2016, and later on, as it creates a high feeling – similar to being drunk.  

Researchers at Oxford University concluded that Pregabalin users have a 26 percent increased rate of suicide. They also theorized that 15 to 24-year-olds are at a greater risk for suicidal thoughts as well as other potential harm that comes with it. This is because younger adults are more likely to be drinkers of alcohol or consumers of other drugs, recreationally, and their combined effect with Pregabalin only makes matters worse. 

The severity of the misuse is grave and it only came to light when distressing incidents were uncovered. People who know the users have described it as “a strange drug” because it makes you get out of your head, for example; someone feeling hot will take their clothes off without any hesitance. In Northern Ireland, it has made its way to the general population and has caused serious harm, as briefed later. In the United Kingdom as a whole, there was a 350 percent increase in the prescription of Pregabalin from 2007 to 2012! The difference between Pregabalin distributions within the UK may have to do with the social and demographic makeup of the regions, but that is only part of the equation while the rest remains a mystery.  

Ideally, Pregabalin is sold only under prescription, but within recent years it has found its way onto the streets over time. Perhaps, the “high” one experiences from Pregabalin is similar to that when drunk – albeit presumably without the harm, and may account for the increase in its abuse and misuse. The euphoria and relaxation from it also keep the user coming back to it. Another reason for the abuse of Pregabalin has been shown to be the fact that it was easily available and that it intensified the effects of heroin, which was like a jackpot for addicts.  

Keeping this in mind, the authorities in the National Health Service United Kingdom formulated a new plan, which came into effect in 2019. This placed a more stringent law on the distribution of Pregabalin, in attempts to control the misuse as much as possible. Specifically, the physician prescribing the drug is only allowed to give an amount that lasts for 30 days. If the period to take the medicine has not been completed by the end of the 30 days, the patient will have to repurchase another prescription within 28 days to get the drug. Online electronic prescriptions were abandoned and the only way to get a new prescription was to set a meeting with the general practitioner in person. If the patient cannot make the visit themselves, they will have to send a representative and/or a family member with an ID card and other special requirements. In either case, only in-person prescriptions would allow the purchase of Pregabalin.   

We will see later on, despite such carefully constructed measures, Pregabalin slips have occurred, leading to detrimental effects on the user.  

Pregabalin abuse and alcohol, as well as tranquilizers, have the same effect (as narrated earlier too). One of the initial symptoms of Pregabalin abuse is the development of tolerance. The user no longer feels the same satisfaction, as they once did, when taking Pregabalin/ Lyrica and have to significantly increase the dosage. Overuse of Pregabalin can also cause rashes, just like those occurring from allergic reactions, attention and concentration impairments, vomiting and nausea, and vertigo. 

Moreover, taking this in order to improve your mood or alleviation means the addiction has crept in. If Pregabalin is not taken for a while, even a day, and the user begins to have withdrawal effects, it can be ascertained that he/she is addicted. Behavioral changes, for example, increased moodiness and irritability, depression, headaches, confusion, sleep disturbances, and nausea are a hand full of the several withdrawal effects of Pregabalin. It must be noted, however, that these withdrawal effects overlap with the side effects of Pregabalin, so one should rely more on the tolerance factor to deduce their current preoccupation with the drug.  

Lyrica alters the way the brain functions, when taken in excess, leading to a noticeable change in one’s behavior and health. It also causes impediments in social relationships and friendships, like all other drugs, as the user goes to extremes to get a hold of the drug. Lyrica can cause severe allergic reactions as well. There has been a fair few reports indicating respiratory illnesses resulting from Pregabalin / Lyrica abuse. These show that people older than 65 and those with renal problems, respiratory illnesses, or any neurological impairment, have a higher risk of respiratory depression. Furthermore, when used in a high dose (300 mg) and in conjunction with opioid medicines, Lyrica overuse is likely to increase the risk of death through opioids. This series of articles from January 2014 to December 2020, totaling 122 reports, highlighted the association of prolonged Pregabalin use and respiratory depression (or dyspnoea). 

In the United Kingdom, the highest approved dose of Pregabalin is 600 mg in a single day. A meta-analysis paper published in August 2020 discovered that 1 percent of the total 13,000 + patients taking Pregabalin are exceeding this approved dose. Although a small number, it is still quite a lot of people who are overdosing. The dangers of this are now provided with empirical evidence:  

A brand-new report, published on 21st August 2021, shows that there have been 186 deaths in the past seven years in Northern Ireland alone due to Pregabalin. As expected, this alarming news has caused the Northern Ireland Formulary to remove it from their list of supplies of drugs. Only doctors will be allowed to give the drug as they will. Yet another report from 2020 found that deaths from Pregabalin have increased by 980 percent in the United Kingdom. Drug abuse has increased generally as well, particularly in Northern Ireland. 

Does Pregabalin cause weight gain? 

Weight gain is, in fact, a side effect of Pregabalin / Lyrica use – that too, one of the most common. This may be because of the increases in appetite and fluid retention caused by Lyrica. A 14-week study showed that participants taking Pregabalin had gained 7 percent more weight at the end of the study, while those who took placebo only gained 2 percent more. This side effect may also cause patients to discontinue treatment.  

For diabetic patients, weight gain through Lyrica was about 1.3 kg. In placebo subjects, it was only 0.3 kg. For a group taking Lyrica for a minimum of two years, the weight gain was 5.2 kg. There is a considerable number of fluctuations regarding weight gain or loss through Lyrica. The same research paper showed that for those taking Lyrica, weight ranged from weight loss of 16 kg to weight gain of 16 kg. Whereas, for placebo participants, the weight ranging from the weight gain of 9 kg to weight loss of 10 kg. 

Weight gain is also more likely, and more common, in patients who take Lyrica as well as another thiazolidinedione medication (a medicine used for type 2 diabetes). 

Most Common Side Effects of Lyrica Abuse in UK

The most common side effects, along with some extremely dangerous and rare ones, of Pregabalin, are: 

1. Dizziness and drowsiness 

2. Increased appetite  

3. Headache  

4. Bloating 

5. Gas and constipation 

6. Nausea 

7. Blurry vision 

8. Slurred and incoherent speech 

9. Dry mouth 

10. Seizures  

11. Depression 

12. Unusual bleeding 

13. Bruising easily (unlike before) 

14. Blueish lips, fingers, and/or toes  

15. Swelling of hands and feet 

16. Twitching of muscles and/or jerking of arms and legs 

17. Difficulty concentrating and/or maintaining concentration 

18. Memory problems, particularly remembering events  

19. Lack of coordination 

20. Weight gain due to increased appetite  

Besides those listed, there can be an array of other side effects too, depending on the person, their body, and their lifestyle. Side effects similar to other anticonvulsants, like rapid eye movements and tremors, can also be experienced by those misusing or abusing Pregabalin. Heavy sweating, hallucinations, pancreatitis, flatulence, first-degree heart block, depression, and seizures are among the side effects that can occur due to the combined effect of Pregabalin and other drugs or even medications.  

Diabetic people who are taking Pregabalin should also watch out for skin sores and redness. Severe side effects that require medical assistance and immediate consultation with a doctor include blurry vision or changes in eyesight, rash and/or itching, breathlessness or other breathing problems, hives, swelling of hands, feet, eyes, mouth, tongue, neck, and/or ankles, chest pain, fever accompanying some sort of muscle fatigue and soreness. It can rarely cause death, but the breathing difficulties, dehydration, seizures, and cardiovascular problems caused by abuse of Pregabalin can prove fatal. 

Adding on, Pregabalin abuse is known to increase the likelihood of suicidal actions in users. Symptoms and signs of this include suicidal thoughts, suicide attempts, aggressiveness, and violent behavior, agitation and irritability, panic attacks, unusual behavioral changes, insomnia, and excessive talking.  

 In recent years, many have associated overdoses in UK and Wales due to increased use of non-opioid painkillers such as pregabalin. These drugs can be particularly dangerous when combined with other drugs such as heroin, as illustrated in a study by the University of Bristol.  Researcher Matthew Hickman has also warned people about an increased risk of overdose due to pregabalin being combined with other drugs, and this can ultimately lead to more deaths due to overdose.  

Signs of Lyrica Overdose  

The escalating number of Lyrica overdoses in the UK has left the citizens concerned. Therefore, it is important to be able to identify a Lyrica overdose as soon as possible and to treat it before it gets worse. Changes in mood, sweating, tremors, agitation, restlessness, mental confusion, irregular blood pressure, and breathing difficulties are common signs of Lyrica overdose. In the case of another opioid being consumed, the signs could vary. In some cases, the signs can be much more severe.   

Death by Pregabalin Overdose 

Pregabalin overdose can even be life-threatening and lead to death. There are some fatal signs of overdose such as vomiting while the patient is unconscious. If the patient stays unconscious for too long, it can lead to brain damage, which in turn could be fatal. In the UK, research illustrated that two-thirds of a time an ambulance was called for a Lyrica overdose, the patient was using some other drug too, such as an opioid. In some of these cases, patients did not make it.  

If you quit taking Lyrica or dramatically reduce the dose after becoming addicted to it, you may experience a variety of withdrawal symptoms. Withdrawal symptoms of Lyrica are quite similar to those of alcohol. These symptoms can become life-threatening in some cases, necessitating medical attention. The severity of your symptoms will vary depending on a number of circumstances, including; 

How often did was the medication taken? 

The dose that was administered 

If the addict was taking other drugs. 

The following are signs and symptoms of Pregabalin withdrawal: 

  • Changes in behavior 
  • Headaches 
  • Mood swings 
  • Anxiety\Depression 
  • Confusion 
  • Suicidal ideation or behavior 
  • Agitation 
  • Nausea 
  • Sweating 
  • Diarrhea 
  • Heart palpitations or a fast heartbeat 
  • Sleeping problems or inability to fall or stay asleep 
  • Seizures 

Some withdrawal symptoms of Lyrica can be quite dangerous, and even life-threatening. Dehydration, heart problems, seizures, relapse and increased chances of an overdose, and suicidal thoughts are all worrisome withdrawal symptoms of pregabalin.  

The Lyrica withdrawal timeline can range from 2 days to several weeks. If the patient stops taking Lyrica suddenly, he/she can experience acute withdrawal symptoms that last a couple of days. The remaining symptoms, nonetheless, can last several weeks. It is advised for patients to gradually stop their misuse of Lyrica to assist in reducing the risk of withdrawal.  

Additionally, in those who have taken significant dosages of the medication or have been consuming it for a long time, the symptoms listed above may last longer or be more severe. 

Managing Lyrica Withdrawal Symptoms (Pregabalin) 

There are several approaches that can be aimed to support in managing the withdrawal symptoms that come with halting Pregabalin consumption. However, because this is a novel chemical in the addiction treatment community and there is a lack of information and research on it, neither is there a specific process that has been created, doctors and treatment institutions provide unique and distinct treatment facilities. 

To reduce the severity of withdrawal symptoms, users should gradually taper off Lyrica under the supervision of a medical practitioner. As previously stated, among persons who have used substantial amounts of Pregabalin or have used it for a longer duration, the timeframe of detox may be more pronounced or prolonged. 

The most appropriate cause of action for those who are addicted to Lyrica is to make use of a detox program. Given that the plan is tailor-made and effective, it can serve as a very effective tool in fighting pregabalin addiction. 

This can aid in the creation of a healthy and relaxing withdrawal time, which will kick-start the healing process. Following the detox and withdrawal period, the patient should enroll in a structured addiction treatment program.  This will boost the individual’s chances of achieving long-term success and will enhance the likelihood of the person attaining long-term sobriety. 

When it comes to Lyrica detox and therapy, there are a number of methods available, the following are considered the most effective: 

Reputable detoxification centers 

Treatment options include inpatient and outpatient options. 

Partial hospitalisation 

There are also a number of drugs that may be used to treat and alleviate the withdrawal symptoms that come with Lyrica addiction. The following are some of the drugs used: 

  • Clonidine is a drug that is commonly used to treat high blood pressure and has a slight sedative effect. 
  • Dexmedetomidine is comparable to clonidine in terms of its effects. 

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