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Pregabalin: Difference between revisions
>Utaninja I have done extensive research on Pregabalin on behalf of TripSit.me for our current research for additions to the current drug combination chart. I apologize if this formatting is not done properly, was not exactly how to use all these sources best. This also through collaboration of many individuals and I will update if there is more research. You can see more conversation on this topic here: https://github.com/TripSit/drugs/discussions/40 |
>Utaninja m Source not checked but adjusting formatting to keep page consistent. |
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The pharmacological action of pregabalin is mediated by binding to the α2δ-1 site of voltage-gated calcium channels.<ref>{{cite journal | vauthors=((Field, M. J.)), ((Cox, P. J.)), ((Stott, E.)), ((Melrose, H.)), ((Offord, J.)), ((Su, T.-Z.)), ((Bramwell, S.)), ((Corradini, L.)), ((England, S.)), ((Winks, J.)), ((Kinloch, R. A.)), ((Hendrich, J.)), ((Dolphin, A. C.)), ((Webb, T.)), ((Williams, D.)) | journal=Proceedings of the National Academy of Sciences | title=Identification of the α 2 -δ-1 subunit of voltage-dependent calcium channels as a molecular target for pain mediating the analgesic actions of pregabalin | volume=103 | issue=46 | pages=17537–17542 | date=14 November 2006 | url=https://pnas.org/doi/full/10.1073/pnas.0409066103 | issn=0027-8424 | doi=10.1073/pnas.0409066103}}</ref><ref name="thromb">{{cite journal | vauthors=((Eroglu, Ç.)), ((Allen, N. J.)), ((Susman, M. W.)), ((O’Rourke, N. A.)), ((Park, C. Y.)), ((Özkan, E.)), ((Chakraborty, C.)), ((Mulinyawe, S. B.)), ((Annis, D. S.)), ((Huberman, A. D.)), ((Green, E. M.)), ((Lawler, J.)), ((Dolmetsch, R.)), ((Garcia, K. C.)), ((Smith, S. J.)), ((Luo, Z. D.)), ((Rosenthal, A.)), ((Mosher, D. F.)), ((Barres, B. A.)) | journal=Cell | title=Gabapentin Receptor α2δ-1 Is a Neuronal Thrombospondin Receptor Responsible for Excitatory CNS Synaptogenesis | volume=139 | issue=2 | pages=380–392 | date= October 2009 | url=https://linkinghub.elsevier.com/retrieve/pii/S0092867409011854 | issn=00928674 | doi=10.1016/j.cell.2009.09.025}}</ref> This site has also been referred to as the gabapentin receptor, as it is the target of the related substance [[gabapentin]] (also developed by Pfizer). Advantages to pregabalin over gabapentin include higher bioavailability and potency. | The pharmacological action of pregabalin is mediated by binding to the α2δ-1 site of voltage-gated calcium channels.<ref>{{cite journal | vauthors=((Field, M. J.)), ((Cox, P. J.)), ((Stott, E.)), ((Melrose, H.)), ((Offord, J.)), ((Su, T.-Z.)), ((Bramwell, S.)), ((Corradini, L.)), ((England, S.)), ((Winks, J.)), ((Kinloch, R. A.)), ((Hendrich, J.)), ((Dolphin, A. C.)), ((Webb, T.)), ((Williams, D.)) | journal=Proceedings of the National Academy of Sciences | title=Identification of the α 2 -δ-1 subunit of voltage-dependent calcium channels as a molecular target for pain mediating the analgesic actions of pregabalin | volume=103 | issue=46 | pages=17537–17542 | date=14 November 2006 | url=https://pnas.org/doi/full/10.1073/pnas.0409066103 | issn=0027-8424 | doi=10.1073/pnas.0409066103}}</ref><ref name="thromb">{{cite journal | vauthors=((Eroglu, Ç.)), ((Allen, N. J.)), ((Susman, M. W.)), ((O’Rourke, N. A.)), ((Park, C. Y.)), ((Özkan, E.)), ((Chakraborty, C.)), ((Mulinyawe, S. B.)), ((Annis, D. S.)), ((Huberman, A. D.)), ((Green, E. M.)), ((Lawler, J.)), ((Dolmetsch, R.)), ((Garcia, K. C.)), ((Smith, S. J.)), ((Luo, Z. D.)), ((Rosenthal, A.)), ((Mosher, D. F.)), ((Barres, B. A.)) | journal=Cell | title=Gabapentin Receptor α2δ-1 Is a Neuronal Thrombospondin Receptor Responsible for Excitatory CNS Synaptogenesis | volume=139 | issue=2 | pages=380–392 | date= October 2009 | url=https://linkinghub.elsevier.com/retrieve/pii/S0092867409011854 | issn=00928674 | doi=10.1016/j.cell.2009.09.025}}</ref> This site has also been referred to as the gabapentin receptor, as it is the target of the related substance [[gabapentin]] (also developed by Pfizer). Advantages to pregabalin over gabapentin include higher bioavailability and potency. | ||
Although pregabalin is a chemical derivative of [[GABA]], it displays no activity at any GABA receptors, including GABA<sub>A</sub>, GABA<sub>B</sub> and the [[benzodiazepine]] site. Pregabalin, despite its GABA backbone, does not appear to alter GABA levels in the brain, so its pharmacological activity is presumed to be unrelated to GABA.<ref>{{cite journal | vauthors=((Taylor, C. P.)), ((Angelotti, T.)), ((Fauman, E.)) | journal=Epilepsy Research | title=Pharmacology and mechanism of action of pregabalin: The calcium channel α2–δ (alpha2–delta) subunit as a target for antiepileptic drug discovery | volume=73 | issue=2 | pages=137–150 | date= February 2007 | url=https://linkinghub.elsevier.com/retrieve/pii/S0920121106003895 | issn=09201211 | doi=10.1016/j.eplepsyres.2006.09.008}}</ref> Instead, it is its binding to the α2δ-1 site of voltage-gated calcium channels which appears to be the source of its subjective effects. By binding to this site, pregabalin reduces the release of several excitatory neurotransmitters, including [[glutamate]], [[substance P]], [[acetylcholine]] and [[norepinephrine]]. | Although pregabalin is a chemical derivative of [[GABA]], it displays no activity at any GABA receptors, including GABA<sub>A</sub>, GABA<sub>B</sub> and the [[benzodiazepine]] site. Pregabalin, despite its GABA backbone, does not appear to alter GABA levels in the brain, so its pharmacological activity is presumed to be unrelated to GABA.<ref>{{cite journal | vauthors=((Taylor, C. P.)), ((Angelotti, T.)), ((Fauman, E.)) | journal=Epilepsy Research | title=Pharmacology and mechanism of action of pregabalin: The calcium channel α2–δ (alpha2–delta) subunit as a target for antiepileptic drug discovery | volume=73 | issue=2 | pages=137–150 | date= February 2007 | url=https://linkinghub.elsevier.com/retrieve/pii/S0920121106003895 | issn=09201211 | doi=10.1016/j.eplepsyres.2006.09.008}}</ref> Instead, it is its binding to the α2δ-1 site of voltage-gated calcium channels which appears to be the source of its subjective effects. By binding to this site, pregabalin reduces the release of several excitatory neurotransmitters, including [[glutamate]], [[substance P]], [[acetylcholine]] and [[norepinephrine]].<ref>{{Cite journal| doi = 10.1124/mol.106.023309| issn = 1521-0111| volume = 70| issue = 2| pages = 467–476| last1 = Micheva| first1 = Kristina D.| last2 = Taylor| first2 = Charles P.| last3 = Smith| first3 = Stephen J.| title = Pregabalin Reduces the Release of Synaptic Vesicles from Cultured Hippocampal Neurons| journal = Molecular Pharmacology| accessdate = 2023-07-14| date = 2006-08-01| url = https://molpharm.aspetjournals.org/content/70/2/467| pmid = 16641316}}</ref> | ||
Reduction in the release of glutamate and acetylcholine might be the cause of dissociative / deliriant like effects in high doses. | Reduction in the release of glutamate and acetylcholine might be the cause of dissociative / deliriant like effects in high doses.{{citation needed}} | ||
One study has also shown that pregabalin promotes deep sleep, thus enhancing sleep quality. This may be substantial because reductions in slow-wave sleep have been associated with anxiety and fibromyalgia.<ref>{{cite journal | vauthors=((Hindmarch, I.)), ((Dawson, J.)), ((Stanley, N.)) | journal=Sleep | title=A double-blind study in healthy volunteers to assess the effects on sleep of pregabalin compared with alprazolam and placebo | volume=28 | issue=2 | pages=187–193 | date= February 2005 | issn=0161-8105 | doi=10.1093/sleep/28.2.187}}</ref> | One study has also shown that pregabalin promotes deep sleep, thus enhancing sleep quality. This may be substantial because reductions in slow-wave sleep have been associated with anxiety and fibromyalgia.<ref>{{cite journal | vauthors=((Hindmarch, I.)), ((Dawson, J.)), ((Stanley, N.)) | journal=Sleep | title=A double-blind study in healthy volunteers to assess the effects on sleep of pregabalin compared with alprazolam and placebo | volume=28 | issue=2 | pages=187–193 | date= February 2005 | issn=0161-8105 | doi=10.1093/sleep/28.2.187}}</ref> | ||
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*'''[[Effect::Spontaneous bodily sensations]]''' - The general "body high" of pregabalin can be described as a sharp, pleasurable tingling sensation which is location specific to the hands, feet, and head. | *'''[[Effect::Spontaneous bodily sensations]]''' - The general "body high" of pregabalin can be described as a sharp, pleasurable tingling sensation which is location specific to the hands, feet, and head. | ||
*'''[[Effect::Physical euphoria]]''' - This component, while prominent in the experience, is generally not as strong as the cognitive euphoria that can be induced. The sensation itself can be described as feelings of physical comfort, warmth and bliss. | *'''[[Effect::Physical euphoria]]''' - This component, while prominent in the experience, is generally not as strong as the cognitive euphoria that can be induced. The sensation itself can be described as feelings of physical comfort, warmth and bliss. | ||
*'''[[Effect::Tactile enhancement]]''' | *'''[[Effect::Tactile enhancement]]''' - Although the user’s body may feel numb, the sense of touch can be heightened at the same time. | ||
*'''[[Effect::Muscle twitching]]''' - Somewhat paradoxically, since pregabalin is used as an adjunct treatment for epilepsy, pregabalin, especially in higher doses, can produce muscle spasms.{{citation needed}} Anecdotally, seizures have been reported in overdose.{{citation needed}} | *'''[[Effect::Muscle twitching]]''' - Somewhat paradoxically, since pregabalin is used as an adjunct treatment for epilepsy, pregabalin, especially in higher doses, can produce muscle spasms.{{citation needed}} Anecdotally, seizures have been reported in overdose.{{citation needed}} | ||
*'''[[Effect::Respiratory depression]]''' - While pregabalin may cause respiratory depression, this effect is not as strong as those with [[opioids]] and [[benzodiazepines]].<ref>{{cite journal | vauthors=((Eipe, N.)), ((Penning, J.)) | journal=Pain Research & Management : The Journal of the Canadian Pain Society | title=Postoperative respiratory depression associated with pregabalin: A case series and a preoperative decision algorithm | volume=16 | issue=5 | pages=353–356 | date= 2011 | url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3206785/ | issn=1203-6765}}</ref> | *'''[[Effect::Respiratory depression]]''' - While pregabalin may cause respiratory depression, this effect is not as strong as those with [[opioids]] and [[benzodiazepines]].<ref>{{cite journal | vauthors=((Eipe, N.)), ((Penning, J.)) | journal=Pain Research & Management : The Journal of the Canadian Pain Society | title=Postoperative respiratory depression associated with pregabalin: A case series and a preoperative decision algorithm | volume=16 | issue=5 | pages=353–356 | date= 2011 | url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3206785/ | issn=1203-6765}}</ref> | ||
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*'''[[Effect::Perception of bodily lightness]]''' - At very high doses, some users report feeling lighter. | *'''[[Effect::Perception of bodily lightness]]''' - At very high doses, some users report feeling lighter. | ||
*'''[[Effect::Increased libido]]''' ''or'' '''[[Effect::Decreased libido]]''' | *'''[[Effect::Increased libido]]''' ''or'' '''[[Effect::Decreased libido]]''' | ||
*'''[[Effect::Difficulty urinating]]'''- This effect is commonly reported by users. | *'''[[Effect::Orgasm depression]]''' - Some may experience a delayed but stronger orgasm even if they experience an increase in libido. | ||
*'''[[Effect::Difficulty urinating]]''' - This effect is commonly reported by users. | |||
*'''[[Effect::Frequent urination]]''' | *'''[[Effect::Frequent urination]]''' | ||
*'''[[Effect::Motor control loss]]''' | *'''[[Effect::Motor control loss]]''' - At higher doses this effect resembles that of [[benzodiazepines]] and [[alcohol]]. Users report stumbling and bumping in to walls. | ||
*'''[[Effect::Seizure suppression]]'''<ref>{{Citation | title=Pregabalin | url=https://www.epilepsy.com/tools-resources/seizure-medication-list/pregabalin}}</ref><ref>{{cite journal | vauthors=((Ryvlin, P.)), ((Perucca, E.)), ((Rheims, S.)) | journal=Neuropsychiatric Disease and Treatment | title=Pregabalin for the management of partial epilepsy | volume=4 | issue=6 | pages=1211–1224 | date= December 2008 | url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2646650/ | issn=1176-6328}}</ref> | *'''[[Tactile suppression]]''' - This effect can result in the whole body feeling numb, particularly one’s face. At the same time the user’s sense of touch can be enhanced. | ||
*'''[[Effect::Seizure suppression]]''' - Pregabalin is effective at reducing certain types of seizures such as focal seizures and partial seizures.<ref>{{Citation | title=Pregabalin | url=https://www.epilepsy.com/tools-resources/seizure-medication-list/pregabalin}}</ref><ref>{{cite journal | vauthors=((Ryvlin, P.)), ((Perucca, E.)), ((Rheims, S.)) | journal=Neuropsychiatric Disease and Treatment | title=Pregabalin for the management of partial epilepsy | volume=4 | issue=6 | pages=1211–1224 | date= December 2008 | url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2646650/ | issn=1176-6328}}</ref> | |||
*'''[[Effect::Pupil dilation]]''' | |||
}} | }} | ||
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*'''[[Effect::Tracers]]''' - This effect can be seen at high doses and is generally quite mild. It generally does not extend past level 2. | *'''[[Effect::Tracers]]''' - This effect can be seen at high doses and is generally quite mild. It generally does not extend past level 2. | ||
*'''[[Effect::Depth perception distortions]]''' - This effect is quite mild and only appears at very high doses. | *'''[[Effect::Depth perception distortions]]''' - This effect is quite mild and only appears at very high doses. | ||
*'''[[Effect::Object alteration]]''' | *'''[[Effect::Object alteration]]''' - Although this effect is rare, it can still occur spontaneously, typically with heavy doses. | ||
*'''[[Effect::Drifting]]''' | *'''[[Effect::Drifting]]''' | ||
*'''[[Effect::After images]]''' and *'''[[Effect::Frame rate suppression]]''' at high / very high doses. These 2 effects together can make your vision feel more 'slow'. | *'''[[Effect::After images]]''' and *'''[[Effect::Frame rate suppression]]''' at high / very high doses. These 2 effects together can make your vision feel more 'slow'. | ||
*'''[[Effect::Double vision]]'''- This effect is quite mild and inconsistently appears at high doses | *'''[[Effect::Double vision]]'''- This effect is quite mild and inconsistently appears at high doses. | ||
====Hallucinatory states==== | ====Hallucinatory states==== | ||
While pregabalin isn't commonly thought off as a | While pregabalin isn't commonly thought off as a hallucinogenic drug, it still can cause dissociative and even psychotic like effects at higher doses. Sleep deprivation and genetics might play a role into the hallucinatory states of Pregabalin. Pregabalin's hallucinatory states are (but not limited to) : | ||
*'''[[Effect::Internal hallucination]]''' - At high dosages, one may experience dream-like states and [[hypnagogia]]. | *'''[[Effect::Internal hallucination]]''' - At high dosages, one may experience dream-like states and [[hypnagogia]]. | ||
*'''[[Effect::External hallucination]]''' - This effect is rare and only | *'''[[Effect::External hallucination]]''' - This effect is rare and only occurs on heavy doses and/or when the user is sleep deprived. This effect can be delirious / psychotic in nature. It can include : [[Object activation]], [[Shadow people]] and [[Transformations]]. It may include even non existent people and animals from a distance, but once the user comes closer they may disappear. | ||
}} | }} | ||
{{effects/disconnective| | {{effects/disconnective| | ||
*'''[[Effect::Visual disconnection]]''' - This effect is generally quite mild and appears inconsistently at high doses. It results in feeling as if one's sense of vision is distant or vague and being viewed through a screen or window. However, pregabalin is rarely reported to cause [[holes, spaces and voids]] or [[Visual_disconnection#Structures|hallucinatory structures]] | *'''[[Effect::Visual disconnection]]''' - This effect is generally quite mild and appears inconsistently at high doses. It results in feeling as if one's sense of vision is distant or vague and being viewed through a screen or window. However, pregabalin is rarely reported to cause [[holes, spaces and voids]] or [[Visual_disconnection#Structures|hallucinatory structures]]. | ||
}} | }} | ||
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The most prominent of these cognitive effects generally include: | The most prominent of these cognitive effects generally include: | ||
*'''[[Effect::Analysis suppression]]''' | *'''[[Effect::Analysis suppression]]''' | ||
* '''[[Effect::Empathy, affection, and sociability enhancement]]''' - Pregabalin presents distinct [[entactogen|entactogen/empathogenic]] effects. In | * '''[[Effect::Empathy, affection, and sociability enhancement]]''' - Pregabalin presents distinct [[entactogen|entactogen/empathogenic]] effects. In contrast to [[benzodiazepines]] (which merely increase sociability through [[disinhibition]]), at high dosages pregabalin directly increases the urge to communicate with others with feelings of empathy, love, closeness and connection being well-defined. These effects, although weaker than that of [[MDMA]], are still prominent. | ||
*'''[[Effect::Ego inflation]]''' | *'''[[Effect::Ego inflation]]''' | ||
*'''[[Effect::Novelty enhancement]]''' | *'''[[Effect::Novelty enhancement]]''' | ||
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*'''[[Effect::Immersion enhancement]]''' | *'''[[Effect::Immersion enhancement]]''' | ||
*'''[[Effect::Creativity enhancement]]''' - This effect is especially noticeable on higher doses. | *'''[[Effect::Creativity enhancement]]''' - This effect is especially noticeable on higher doses. | ||
*'''[[Effect::Depersonalization]]''' ''and'' '''[[Effect::Derealization]]''' - At | *'''[[Effect::Depersonalization]]''' ''and'' '''[[Effect::Derealization]]''' - At heavy doses, pregabalin can induce a mild dissociative state. The DPDR from pregabalin can be increased and made more ''negative'' (dysphoric) by sleep deprivation. | ||
*'''[[Effect::Suicidal ideation]]''' - In | *'''[[Effect::Suicidal ideation]]''' - In heavy doses, this can lead to suicide attempts. | ||
*'''[[Effect::Psychosis]]''' - Even at | *'''[[Effect::Psychosis]]''' - Even at therapeutic doses, pregabalin has been shown to have psychotic side effects in a minority of it's users <ref>{{cite journal | vauthors=((Olaizola, I.)), ((Ellger, T.)), ((Young, P.)), ((Bösebeck, F.)), ((Evers, S.)), ((Kellinghaus, C.)) | journal=Seizure | title=Pregabalin-associated acute psychosis and epileptiform EEG-changes | volume=15 | issue=3 | pages=208–210 | date=1 April 2006 | url=https://www.sciencedirect.com/science/article/pii/S105913110600029X | issn=1059-1311 | doi=10.1016/j.seizure.2006.02.004}}</ref><ref>{{cite journal | vauthors=((Mousailidis, G.)), ((Papanna, B.)), ((Salmon, A.)), ((Sein, A.)), ((Al-Hillawi, Q.)) | journal=BMC Pharmacology and Toxicology | title=Pregabalin induced visual hallucinations – a rare adverse reaction | volume=21 | issue=1 | pages=16 | date=28 February 2020 | url=https://doi.org/10.1186/s40360-020-0395-6 | issn=2050-6511 | doi=10.1186/s40360-020-0395-6}}</ref>. Sleep deprivation strongly potentiates this effect, which may be higher for people genetically predisposed to schizophrenia. | ||
*'''[[Effect::Mania]]''' - | *'''[[Effect::Mania]]''' - When used to treat bipolar disorder <ref>{{cite journal | vauthors=((Schaffer, L. C.)), ((Schaffer, C. B.)), ((Miller, A. R.)), ((Manley, J. L.)), ((Piekut, J. A.)), ((Nordahl, T. E.)) | journal=Journal of Affective Disorders | title=An open trial of pregabalin as an acute and maintenance adjunctive treatment for outpatients with treatment resistant bipolar disorder | volume=147 | issue=1–3 | pages=407–410 | date= May 2013 | issn=1573-2517 | doi=10.1016/j.jad.2012.09.005}}</ref>,it can cause mania, even from therapeutic doses.<ref>{{cite journal | vauthors=((Yukawa, T.)), ((Suzuki, Y.)), ((Fukui, N.)), ((Otake, M.)), ((Sugai, T.)), ((Someya, T.)) | journal=Psychiatry and Clinical Neurosciences | title=Manic symptoms associated with pregabalin in a patient with conversion disorder | volume=67 | issue=2 | pages=129–130 | date= February 2013 | url=https://onlinelibrary.wiley.com/doi/10.1111/pcn.12012 | issn=13231316 | doi=10.1111/pcn.12012}}</ref>. This effect typically occurs in a recreational settings, with heavy doses, or when the user is sleep-deprived. It can appear low in intensity (hypomania) or synergize with [[psychosis]]. However, this effect is rare, and it's not a part of the typical experience. | ||
*'''[[Effect::Thought deceleration]]''' | *'''[[Effect::Thought deceleration]]''' | ||
}} | }} | ||
{{effects/auditory| | {{effects/auditory| | ||
*'''[[Effect::Auditory enhancement | *'''[[Effect::Auditory enhancement]]''' | ||
*'''[[Effect::Auditory distortion | *'''[[Effect::Auditory distortion]]''' - These are usually mild and only present at extremely high doses. | ||
*'''[[Effect::Auditory hallucination]]''' - | *'''[[Effect::Auditory hallucination]]''' - At heavier dosages, one may experience tinnitus or the perception of imagined sounds, such as voices. | ||
}} | }} | ||
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==Toxicity and harm potential== | ==Toxicity and harm potential== | ||
Pregabalin likely has a [[Toxicity::low toxicity]] relative to dose. However, it is potentially [[respiratory depression|lethal]] when mixed with [[depressants]] like [[alcohol]] or [[opioids]]. | Pregabalin likely has a [[Toxicity::low toxicity]] relative to dose. However, it is potentially [[respiratory depression|lethal]] when mixed with [[depressants]] like [[alcohol]] or [[opioids]]. | ||
===Seizure Risk=== | |||
Pregabalin has been shown to induce and or increase the risk of seizures at recreational dosages.<ref>https://doi.org/10.1101/cshperspect.a022863</ref><ref>https://doi.org/10.1111/j.0013-9580.2004.455003.x</ref><ref>https://doi.org/10.1111/j.0013-9580.2004.455003.x</ref> There is little evidence showing there is a concern at medical dosages (600mg and under). This risk may be increased when mixed with other drugs that lower seizure threshold. Caution is recommended when using doses of higher than 600mg. Reducing various susceptibility factors may also be beneficial in lowering this risk. Susceptibility factors may include things such as low sodium, lack of sleep, and intensive physical activity. | |||
It is strongly recommended that one use [[responsible drug use|harm reduction practices]] when using this substance. | It is strongly recommended that one use [[responsible drug use|harm reduction practices]] when using this substance. | ||
===Lethal dosage=== | ===Lethal dosage=== | ||
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*'''Sweden:''' Pregabalin is a prescription drug. classified as a controlled substance, as a schedule V drug, since 24 july 2018 <ref>https://lakemedelsverket.se/Alla-nyheter/NYHETER---2018/Pregabalin-narkotikaklassas/</ref> | *'''Sweden:''' Pregabalin is a prescription drug. classified as a controlled substance, as a schedule V drug, since 24 july 2018 <ref>https://lakemedelsverket.se/Alla-nyheter/NYHETER---2018/Pregabalin-narkotikaklassas/</ref> | ||
*'''Switzerland:''' Pregabalin is listed as a "Abgabekategorie B" pharmaceutical, which requires a prescription.{{citation needed}} | *'''Switzerland:''' Pregabalin is listed as a "Abgabekategorie B" pharmaceutical, which requires a prescription.{{citation needed}} | ||
*'''Turkey''': Pregabalin is a 'green prescription' only substance<ref>YEŞİL REÇETEYE TABİ İLAÇLAR | https://www.titck.gov.tr/storage/Archive/2019/contentFile/01.04.2019%20SKRS%20Ye%C5%9Fil%20Re%C3%A7eteli%20%C4%B0la%C3%A7lar%20Aktif%20SON%20-%20G%C3%9CNCEL_58b1ff4a-2e1c-4867-bad7-eec855d6162a.pdf</ref> | *'''Turkey''': Pregabalin is a 'green prescription' only substance and illegal when sold or possessed without a prescription.<ref>YEŞİL REÇETEYE TABİ İLAÇLAR | https://www.titck.gov.tr/storage/Archive/2019/contentFile/01.04.2019%20SKRS%20Ye%C5%9Fil%20Re%C3%A7eteli%20%C4%B0la%C3%A7lar%20Aktif%20SON%20-%20G%C3%9CNCEL_58b1ff4a-2e1c-4867-bad7-eec855d6162a.pdf</ref>{{citation needed}} | ||
*'''United Kingdom:''' The Misuse of Drugs Act 1971 makes it illegal to possess the drug without a prescription and, for such purposes, it is classified as a Class C drug.<ref>{{Citation | title=The Misuse of Drugs Act 1971 (Amendment) Order 2018 | url=https://www.legislation.gov.uk/uksi/2018/1356/article/2/made}}</ref> | *'''United Kingdom:''' The Misuse of Drugs Act 1971 makes it illegal to possess the drug without a prescription and, for such purposes, it is classified as a Class C drug.<ref>{{Citation | title=The Misuse of Drugs Act 1971 (Amendment) Order 2018 | url=https://www.legislation.gov.uk/uksi/2018/1356/article/2/made}}</ref> | ||
*'''United States:''' Pregabalin is in Schedule V, indicating "low potential for abuse." For comparison, benzodiazepines are in Schedule IV.<ref>{{Citation | year=2016 | title=Title 21 CFR - PART 1308 - Section 1308.15 Schedule V | url=http://web.archive.org/web/20161017105621/https://www.deadiversion.usdoj.gov/21cfr/cfr/1308/1308_15.htm}}</ref> | *'''United States:''' Pregabalin is in Schedule V, indicating "low potential for abuse." For comparison, benzodiazepines are in Schedule IV.<ref>{{Citation | year=2016 | title=Title 21 CFR - PART 1308 - Section 1308.15 Schedule V | url=http://web.archive.org/web/20161017105621/https://www.deadiversion.usdoj.gov/21cfr/cfr/1308/1308_15.htm}}</ref> | ||
<br /> | |||
== Combinations == | |||
with [[Memantine]] (anecdotal, N=1)<blockquote>Add-on of 20mg to 30mg Memantine per day to 75mg Pregabalin is equivalent to 300mg Pregabalin (I had tolerance of that much at the time. I have chronic anxiety)</blockquote> | |||
==See also== | ==See also== | ||