Pregabalin Group Research Articles

Effectiveness of Pregabalin Treatment for Neuropathic Pain in Patients with Spine Diseases: A Pooled Analysis of Two Multicenter Observational Studies in Japan.

PurposeNeuropathic pain (NeP) is common among patients with chronic pain associated with spine diseases. Practical effectiveness of pregabalin, one of the first-line treatments for NeP, has not been evaluated in an entire population of patients with spine diseases, including various pathophysiological conditions. This pooled analysis aimed to evaluate the therapeutic value of pregabalin for chronic pain with NeP component in patients with spine diseases in routine primary care settings.Patients and MethodsWe pooled data from two 8-week prospective observational cohort studies for patients with chronic low back pain with accompanying lower limb pain (NeP component), and patients with chronic cervical pain and accompanying upper limb radiating pain (NeP component) in routine primary care settings in Japan. For both studies, patients were treated for 8 weeks with pregabalin (alone/with other analgesics) or usual care with conventional analgesics (eg, non-steroidal anti-inflammatory drugs). Changes in pain numerical rating scale (NRS), Pain-Related Sleep Interference Scale (PRSIS), and EuroQol 5-dimension 5-level (EQ-5D-5L) scores from baseline to week 8 were summarized and compared between the pregabalin and usual care groups, and also for subgroups of primary diagnosis. Safety was evaluated by adverse events (AEs) in the pregabalin group.ResultsThe pooled dataset comprised 700 patients (pregabalin group: 302; usual care group: 398). All patient-reported outcomes (PRO) scores significantly improved from baseline to week 8 in the pregabalin than in the usual care group (NRS: P<0.0001; PRSIS: P<0.0001, and EQ-5D-5L: P=0.0006). Overall, all three PRO measures showed greater improvement in the pregabalin than in the usual care group, irrespective of the primary diagnosis. AEs were reported in 36.1% of the pregabalin group.ConclusionThis analysis suggested multi-faceted effectiveness of treatment with pregabalin from the patient’s perspectives under a “real-world” practice in all patients with chronic NeP from various spine diseases.

Comparison of the effect of oral pregabalin with intravenous ketamine on reducing acute pain after abdominal hysterectomy: A randomized double-blind clinical trial.

Background:The aim of this study was to compare the analgesic effects of pregabalin and ketamine on reducing pain after abdominal hysterectomy.Methods:In this double-blind clinical trial, one hundred forty ASA I and II patients of age range 30-60 years scheduled for abdominal hysterectomy undergoing general anesthesia in 2018, were randomly divided into 4 equal groups. Pregabalin group received 300 mg oral pregabalin, ketamine group received 0.3 mg/kg of intravenous ketamine, and pregabalin- ketamine group received the combination of the two-above medication, and placebo group received the placebo and saline. Patients were evaluated for pain intensity according to the visual analogue scale (VAS) at 2, 4, 6, 12, 18, and 24 hours after surgery. Also, the need for analgesic drugs and the frequency of repetitions were also recorded. Statistical analysis was performed using STATA, Version 14. A p- value less than 0.05 was considered statistically significant.Results:In the pregabalin and pregabalin-ketamine groups, pain in the first 6 hours after the end of operation was significantly less than the other two groups (p<0.05), but there was no significant difference between the 4 groups at 18 and 24 hours after surgery. The need for analgesic medications in the pregabalin group was lower than in other groups (p<0.05).Conclusion:The results of this study show that the administration of oral pregabalin with and without intravenous ketamine before abdominal hysterectomy can decrease postoperative pain and reduce the need for analgesia.

Effects of pre-emptive pregabalin and multimodal anesthesia on postoperative opioid requirements in patients undergoing robot-assisted laparoscopic prostatectomy

BackgroundPrevious findings indicate that pre-emptive pregabalin as part of multimodal anesthesia reduces opioid requirements compared to conventional anesthesia in patients undergoing robot-assisted laparoscopic prostatectomy (RALP). However, recent studies show contradictory evidence suggesting that pregabalin does not reduce postoperative pain or opioid consumption after surgeries. We conducted a register-based analysis on RALP patients treated over a 5-year period to evaluate postoperative opioid consumption between two multimodal anesthesia protocols.MethodsWe retrospectively evaluated patients undergoing RALP between years 2015 and 2019. Patients with American Society of Anesthesiologists status 1–3, age between 30 and 80 years and treated with standard multimodal anesthesia were included in the study. Pregabalin (PG) group received 150 mg of oral pregabalin as premedication before anesthesia induction, while the control (CTRL) group was treated conventionally. Postoperative opioid requirements were calculated as intravenous morphine equivalent doses for both groups. The impact of pregabalin on postoperative nausea and vomiting (PONV), and length of stay (LOS) was evaluated.ResultsWe included 245 patients in the PG group and 103 in the CTRL group. Median (IQR) opioid consumption over 24 postoperative hours was 15 (8–24) and 17 (8–25) mg in PG and CTRL groups (p = 0.44). We found no difference in postoperative opioid requirement between the two groups in post anesthesia care unit, or within 12 h postoperatively (p = 0.16; p = 0.09). The length of post anesthesia care unit stay was same in each group and there was no difference in PONV Similarly, median postoperative LOS was 31 h in both groups.ConclusionPatients undergoing RALP and receiving multimodal analgesia do not need significant amount of opioids postoperatively and can be discharged soon after the procedure. Pre-emptive administration of oral pregabalin does not reduce postoperative opioid consumption, PONV or LOS in these patients.

The Clinical Difference between Gabapentin and Pregabalin: Data from a Pilot Comparative Trial.

Similar anticonvulsants, such as gabapentin and pregabalin are recommended in neuropathic pain management, however little is known about their clinical differences in cases of low back pain. This paper aims to highlight some of the possible clinical differences between gabapentin and pregabalin in low back pain. Patients with moderate to severe low back pain were recruited. Eligible patients were randomised to receive either pregabalin (300 mg/day)or gabapentin (800 mg/day) for six weeks. The primary outcome measure was pain intensity according to the Visual Analogue Score (VAS) at baseline and at six weeks. The secondary outcome measures were: anxiety, insomnia, fatigue and the self-rated (GCI), measured at baseline, second, fourth, and the sixth week. A total of 64 patients, pregabalin group (n=28), gabapentin group (n=36) completed the study. While pregabalin group showed a significantly lower pain score (p=0.039). The gabapentin group showed significant improvement in anxiety (p=0.001), insomnia (p=0.001), general fatigue (p=0.009), physical fatigue (p=0.001), reduce activity (p=0.001), and mental fatigue (p=0.014) higher than that of pregabalin. No difference in (GCI) was seen at six weeks. This is the first trial aimed at comparing gabapentin with pregabalin in NLBP. Although the results are preliminary, in our pilot study pregabalin was found to be superior in pain reduction, gabapentin demonstrated better effect on anxiety, insomnia and fatigue symptoms. The results are preliminary and studies with a larger sample size are still required.

EFFICACY AND SAFETY OF GABAPENTIN AND PREGABALIN IN CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY

Objectives: Chemotherapy-Induced Peripheral Neuropathy (CIPN) occurs as a common Adverse Drug Reaction (ADR) of anti-cancer drugs. The prevalence varies from 10% to 100%. To date, there is no standard effective treatment protocol for this condition. However, the neuro-modulators such as gabapentin and pregabalin are increasingly being used to treat CIPN. With this background this study was undertaken to compare the efficacy and safety of gabapentin and pregabalin in CIPN.&#x0D; Methods: This study was conducted in the department of medical oncology at Vydehi Institute of Medical Sciences and Research Centre, Bengaluru. It was initiated after the approval from Institutional Ethics Committee. After obtaining written informed consent, the participants were randomized into two groups. Group A received gabapentin, 300 mg orally and Group B received pregabalin 75 mg orally; twice daily for 8 weeks. They were followed up at 2, 4, and 8 weeks. The intensity and quality of pain were assessed by visual analog scale (VAS) and pain quality assessment scale (PQAS). Safety was assessed by reported ADR. Data were analyzed using Student’s t-test and Mann–Whitney U-test. p=0.05 or less was considered as statistically significant.&#x0D; Results: Reduction in VAS and PQAS scores at 8 weeks was statistically significant in each group (p&lt;0.0001). The ADR common to both the groups was drowsiness and sedation. The prevalence of ADR was more in the gabapentin group.&#x0D; Conclusion: Both gabapentin and pregabalin have similar clinical efficacy in the treatment of CIPN. The prevalence of ADR was higher in gabapentin group compared to pregabalin group.

A prospective observational study to assess drug aberrant behaviours in chronic pain patients on gabapentinoids

Aim: The aim is to explore whether addiction or drug aberrant behavior exists among patients being treated with pregabalin or gabapentin in our outpatient service. Methods: A self-administered questionnaire, the current opioid misuse measure (COMM) was distributed to all patients attending the outpatient service. They filled this voluntarily with maintenance of complete anonymity and confidentiality. Statistical analysis was conducted using the SPSS software. Results: A total of 52 questionnaires were received. Twenty-one patients were on gabapentin and 19 on pregabalin. Eighty percent of the patients had little or no benefit and yet an attempt to taper the doses was made only in 37.8% patients. About 56.9% patients had COMM scores above 9, the cut off value for detecting drug abuse/misuse. The COMM scores showed a positive association with the dose magnitude of gabapentin (P = 0.006) but not pregabalin. They also showed a significant positive correlation with the duration of treatment with pregabalin (P = 0.000). The Mann–Whitney U-test showed that the COMM scores were significantly higher in the pregabalin group (P = 0.022). Conclusions: Our findings suggest gabapentinoids do carry a potential risk of addiction. Pregabalin more than gabapentin may have a potential for drug aberrant behavior. We must regularly review patient's doses and duration of treatment. Large scale studies are needed to validate the findings. Setting up of national pharmacovigilance databases may be the way forward in preventing a potential drug abuse problem.

Effect of pregabalin versus midazolam premedication on the anesthetic and analgesic requirements in pediatric day-case surgery: A randomized controlled trial

ABSTRACT Background: This study aimed to compare pregabalin and midazolam premedication in pediatric day-case surgery regarding anesthetic and analgesic requirements.Methods: Sixty patients scheduled for day-case surgery were randomly premedicated orally with either pregabalin (Group P) or midazolam (Group M). Intraoperative anesthetic and analgesic requirements were assessed as primary outcomes. Modified Ramsay Sedation Score (RSS), hemodynamic variables, time to eye opening and time to extubation after discontinuation of general anesthesia were measured. Post-anesthesia care unit (PACU) duration of stay, postoperative Pediatric Anesthesia Emergence Delirium (PAED) scale, and Faces Legs Activity Cry Consolability (FLACC) scale, and post-operative analgesic requirements were assessed as secondary outcomes. The study was pre-registered at the Pan African Clinical Trials Registry (registration number: PACTR201907535888819; date of registration: 22/07/2019).Results: We found no significant differences between the studied groups regarding types and duration of surgery, preoperative modified RSS, and postoperative PAED. The mean ranks of sevoflurane and fentanyl consumptions were significantly lower in group P (p < 0.001). Patients in group P showed significantly lower means of heart rate and arterial blood pressure after induction of anesthesia. Postoperative FLACC pain score showed a significantly lower mean rank in group P. The need for rescue analgesics and the mean ranks of rectal diclofenac and meperidine consumption was significantly lower in group P (p < 0.001). The mean ranks of total paracetamol doses were comparable in both groups (p = 0.090). Group P showed a significantly lower duration of stay in PACU and time to open the eye and to extubate, but significantly higher time to first analgesic requirement.Conclusion: Pregabalin significantly reduced the perioperative anesthetic and analgesic requirements, the PACU duration of stay, and the time to open the eye and to extubate, in comparison to midazolam; therefore, its use as a premedication in pediatric day-case surgery is recommended.

Efficacy of Pregabalin as preemptive analgesic in laparoscopic cholecystectomy

Introduction: Different pharmacological approach for preemptive analgesia have been tried with varying degree of success. Preemptive analgesia results in decrease in postoperative opioid requirement and hence decreases opioid related complication.&#x0D; Objectives: This study aims to evaluate pregabalin as preemptive analgesic in scheduled cases.&#x0D; Methodology: Fourty ASA I and II patients posted for elective laparoscopic cholecystectomy under general anesthesia were divided into two groups of twenty. Group A received pregabalin 300 mg, two hours before induction of anesthesia but group B were not given any medication. Postoperative VAS Score, Ramsay Sedation Score, postoperative nausea and vomiting and postoperative opioid requirement in two groups were observed over 48 hours and noted.Results: The mean VAS scores were higher in control group whereas the mean Ramsay score was higher in group pregabalin in the first six hours in the post operative period which was statistically significant. The mean Ramsay sedation score was same (2) in both the group after twelve post operative period. Postoperative nausea and vomiting was lower in the pregabalin group. Requirement of post operative analgesia was higher in the control group.&#x0D; Conclusion: Preemptive use of Pregabalindecreasespostoperateive pain, postoperative opioid requirement and increases postoperative sedation.

A randomized study to determine the efficacy of pregabalin for the treatment of moderate or severe baseline neuropathic pain at a tertiary care centre in Ganjam, Odisha

Background: Neuropathic pain (NeP) is caused by a disease like lesion; it is the disease of the somatosensory nervous system. NeP also caused some severe health disorders such as diabetic peripheral neuropathy (DPN), postherpetic neuralgia (PHN), and spinal cord injury (SCI). Along with the severe health issues, NeP adversely affects the quality of life (QOL) as well as an economic burden on the infected persons and their family plus society. Aim: The aim of the study is to define the efficiency of pregabalin for the treatment of moderate or severe baseline neuropathic pain at a tertiary care centre in Ganjam, Odisha. Materials and Methods: It was a randomized study conducted between August 2019 and January 2020 at the MKCG Medical College Berhampur, Ganjam, Odisha on 700 patients. Simple randomization technique was employed to give patients either pregabalin or placebo. All the patients aged >18 years were selected for the study. The pain was assessed for all the patients using the 11-point numeric rating scale, where 0 = no pain and 10 = worst possible pain. All the patients having pain score >4 were involved in the study. Patients who were below 18 years of age were omitted from the study. Further, the patients whose pain score was below four were also omitted from the study. Results: It was observed that there were 455 patients in the Pregabalin group, and in the placebo group, there were 245 patients. The patients were also bifurcated as per the severity of their discomfort, in which 513 patients were comprised in the moderate section, whereas 187 patients were encompassed in the severe section. 63-71 years was the median age. In the moderate and severe pain group, standard mean pain scores were equivalent among the pregabalin and placebo treatment groups. There was a statistically significant difference among both the groups with respect to the change in pain score. This implies that pregabalin reduced pain more significantly as compared to the

Effect of oral low dose pregabalin on succinylcholine induced fasciculations and myalgia -A prospective randomized double blind placebo-controlled study

Introduction: Among the depolarizing muscle relaxants, Succinylcholine is the widely used depolarizing agent until today in anaesthesia practice. Side effects like hyperkalemia, fasciculations, myalgia, increased intracranial pressure and intraocular pressure are common with the use of this drug. Pretreatment with various drugs have been proven to lessen these side effects. In our study, low dose of oral pregabalin was used as a premedication to assess its effects on the incidence and severity of fasciculations and postoperative myalgia caused by Succinylcholine administration. Materials and Methods: 60 patients of either gender undergoing elective ENT surgeries under general anaesthesia were randomly allocated to two groups of 30 each. Patients in Group PG (pregabalin group) received 75 mg of pregabalin orally 1 h prior to surgery and patients in Group CG (control group) received matching placebo. Fasciculations and myalgia grading was done by a blinded observer. Haemodynamic variables were measured at regular intervals. Results: Both groups were comparable in regard to Demographic data (p > 0.05). We didn’t find any significant difference in the fasciculations incidence (p=0.702) and myalgia incidence (p=0.081) between the two groups. But the severity of fasciculations is statistically significant between the groups (< 0>P < 0> Conclusion: Low dose oral pregabalin- 75 mg decreases the severity of succinylcholine-induced fasciculations and myalgia. There is not much effect on the incidence of fasciculations and myalgia in patients undergoing elective ENT surgeries. Keywords: Succinylcholine, Low dose Pregabalin, Fasciculations, Myalgia.

Effects of taking pregabalin (Lyrica) on the severity of dry eye, corneal sensitivity and pain after laser epithelial keratomileusis surgery

BackgroundCorneal nerve damage after laser epithelial keratomileusis (LASEK) is thought to be the cause of dry eye and pain. Therefore, we investigated whether taking pregabalin (Lyrica), which reduces peripheral neuropathic...

Protective effect of pregabalin on the brain tissue of diabetic rats.

Diabetes mellitus (DM) is a metabolic disorder characterized by insulin deficiency or insulin resistance. Pregabalin (PGB) is an antiepileptic drug with proven efficacy in the treatment of epilepsy, generalized anxiety disorder, and neuropathic pain. In this study, we aimed to investigate the protective effects of PGB in brain tissue of rats with streptozotocin (STZ)-induced experimental diabetes. Twenty-eight Wistar albino male rats were randomly divided into four groups with seven rats each: (I) Control group, (II) PGB (50mg/kg PBG), (III) DM, and (IV) DM + PGB (50mg/kg/day PGB per orally for 8weeks). Diabetes was induced with an intraperitoneal (i.p.) STZ injection (Sigma Chemical Co Louis Missour, USA) at a dose of 180mg/kg. STZ was dissolved in 0.1M phosphate-citrate tampon (pH 4.5). Paraffin sections were examined using histological and immunohistochemical analyses. To detect oxidative damage biochemically, malondialdehyde (MDA), the end product of lipid peroxidation; superoxide dismutase (SOD), catalase (CAT), glutathione (GSH) and glutathione peroxidase (GPx) which are antioxidant enzymes, levels were studied. In addition, bax, caspase-3 enzyme activities and TUNEL assay were studied to evaluate the apoptosis status. In the DM group, MDA concentrations were significantly higher and GPx and SOD activities were significantly lower compared to the control group. MDA concentrations were significantly lower and SOD activity was significantly higher in the DM + PGB group than in the DM group. The GPx activity in the DM group decreased significantly compared to the control group. In immunohistochemical examinations (Bax, Caspase-3 and TUNEL), the apoptosis rate was significantly lower in the in DM + PGB group than in the DM group. Pregabalin may prevent harmful effects of oxidative damage by decreasing the MDA levels and increasing the SOD levels. In addition, it was thought that PGB may have antiapoptotic properties due to decreased bax and caspase-3 immunoreactivity and TUNEL positivity in PGB groups. Based on these findings, we think that PGB may be effective in reducing the risk of brain damage associated with DM.

Efficacy and safety of mirogabalin treatment in patients with diabetic peripheral neuropathic pain: A systematic review and meta-analysis of randomised controlled trials.

We aimed to perform a systematic review and meta-analysis to examine the efficacy and safety of mirogabalin in patients with diabetic peripheral neuropathic pain (DPNP). We searched four databases from inception to 1st July 2020. We included all randomised controlled trials (RCTs) which assessed the effectiveness and safety of mirogabalin in patients with DPNP. We evaluated the quality of the included RCTs using the Cochrane risk of bias assessment tool. We pooled dichotomous outcomes as risk ratios and continuous outcomes as mean differences with 95% confidence intervals, both under the random- or fixed-effects model. Three RCTs matched our inclusion criteria with a total of 1732 patients with DPNP: 1057, 534 and 141 patients received mirogabalin, placebo and pregabalin, respectively. The quality of included RCTs was marked as moderate-to-high. Mirogabalin treatment was significantly associated with a significant reduction in the average daily pain score (ADPS) compared with placebo over 7weeks. Compared with pregabalin, mirogabalin was significantly associated with more decrease in ADPS only after 3, 4 and 5weeks. The proportion of patients with ≥30% and ≥50% reduction in the ADPS was significantly higher in the mirogabalin vs placebo and pregabalin groups. Compared with placebo, mirogabalin was significantly associated with more adverse events of dizziness, increased weight, peripheral oedema and somnolence. The safety profile was comparable between mirogabalin and pregabalin. Our systematic review and meta-analysis revealed that in patients with DPNP, mirogabalin treatment was superior to placebo and pregabalin in decreasing the ADPS over time. Besides, mirogabalin was largely safe and associated with some adverse events that could be managed conservatively.

Use of Pregabalin as Preemptive Analgesia for Decreasing Postoperative Pain in Tympanoplasty.

Tympanoplasty is a commonly performed surgical procedure done by Otorhinolaryngologist for treatment of chronic suppurative otitis media. Postoperative period requires the use of analgesics which are given regularly. The study aims to assess the efficacy of a single dose of preemptive pregabalin in decreasing postoperative pain after postauricular type 1 tympanoplasty. This randomized prospective study was carried out in a tertiary care hospital between July 2017 and April 2018. A total of 60 patients were divided into two groups of 30 each. This study analyzed the effect of single preoperative use of pregabalin 150mg oral 1h before type 1 postauricular tympanoplasty for postoperative pain as a VAS (visual analogue scale) score and requirement of rescue analgesia and results were compared with the placebo group. Pain scores (VAS score) was significantly lower in the pregabalin group as compared to the placebo group at 6, 12, 24, and at 48h. Rescue analgesia requirements were also lower in the pregabalin group than the placebo group. Preemptive use of a single dose of oral 150mg pregabalin reduces postoperative pain and rescue analgesic requirement in patients undergoing type 1 tympanoplasty.

Effects of Single-Dose Preoperative Pregabalin on Postoperative Pain and Opioid Consumption in Cleft Orthognathic Surgery.

Several studies have illustrated the efficacy of pregabalin in decreasing postoperative opioid use in adults undergoing orthognathic surgery. We aimed to study the effects of a single dose of preoperative pregabalin on total opioid consumption after orthognathic surgery in individuals with cleft lip and palate. This is a retrospective cohort study of consecutive patients who underwent Le Fort I midface advancement between June 2012 and July 2019. All patients had a diagnosis of cleft lip and palate. The treatment group received a 1-time preoperative dose of pregabalin; the control group did not. Total morphine milligram equivalent (MME) consumption was calculated by adding intraoperative and postoperative opioid use during admission. Twenty-three patients were included in this study; 12 patients received pregabalin. The pregabalin group had significantly lower total opioid consumption (total MME 70.95 MME; interquartile range [IQR]: 24.65-150.17) compared to the control group (138.00 MME; IQR: 105.00-232.48) (MU = 31.00, P = 0.031). The difference in mean pain scores in the treatment group (3.21 ± 2.03) and the control group (3.71 ± 2.95) was not statistically significant (P = 0.651, 95% confidence interval -1.75 to 2.75). A 1-time preoperative dose of pregabalin before orthognathic surgery in patients with cleft lip and palate reduced total opioid consumption during admission without increasing patient pain. A single preemptive dose of pregabalin should be considered an effective adjunct to pain management protocols in patients undergoing orthognathic surgery.

Comparing Effectiveness of Gabapentin and Pregabalin in Treatment of Neuropathic Pain: A Retrospective Cohort of Palliative Care Outpatients

Gabapentin and pregabalin are often considered first line treatment options for various neuropathic pain conditions. The purpose of this retrospective cohort study was to compare clinically meaningful pain reduction and other relevant outcomes among patients prescribed either gabapentin or pregabalin at the University of Arkansas for Medical Sciences (UAMS) Palliative Care Clinic (PCC). The primary endpoint was a significant improvement in pain within six months of initiating either gabapentin or pregabalin. Secondary endpoints included the average number of pills per day as documented at last visit in the study period, the incidence of gabapentinoid dose reductions due to adverse effects, and the incidence of discontinuation of a gabapentinoid due to adverse effects. 222 patients were included in the gabapentin group and 30 patients were included in the pregabalin group. There was not a statistically significant difference between the groups in the primary outcome of pain reduction (p = 0.43). Dose reductions due to adverse effects were statistically significantly (p = 0.03) higher in the gabapentin group than the pregabalin group. The average number of pills per day by a patient in the gabapentin group was 1.8 pills higher than the pregabalin group which was statistically significant (p = 0.01). The results of this analysis support the notion that there is no significant difference in meaningful pain reduction with gabapentin versus pregabalin. This study demonstrates that pregabalin may afford better tolerability and lower pill burden compared to gabapentin.

Comparison of Pregabalin Versus Placebo in Reduction of Pain due to Lumber Disc Herniation.

Introduction Lower back pain is an extensive problem globally, and quite prevalent in Pakistan as well. In most cases of lower back pain, the cause is lumbar disc herniation. To treat this pain, there are various treatment options available. In this study, we aim to find the efficacy and safety of pregabalin in lower back pain due to lumbar disc herniation.Methods We conducted an open-label prospective trial in a public tertiary care hospital in Karachi, Pakistan, for a duration of five months, i.e. from July 2019 to December 2019. A total of 105 patients were randomized into two groups: pregabalin group and placebo group, and they were required to respond to visual analog scale (VAS) on day 0 and week 12 of the study.ResultsThe results showed a significant reduction in pain over time in both the groups: pregabalin (p-value < 0.0001) and placebo (p-value < 0.0001). However, the difference in pain reduction between pregabalin and placebo was not significant (p-value = 0.57). The most commonly reported side effects were somnolence and dizziness.Conclusion Based on the results of this study, we conclude that adding pregabalin to non-steroidal anti-inflammatory drugs (NSAIDs) and physiotherapy had no significant effect on pain reduction. Further large-scale studies are needed to evaluate the role of gabapentoids in lower back pain due to lumbar disc herniation.

Pregabalin induced reproductive toxicity and body weight changes by affecting caspase3 and leptin expression: Protective role of wheat germ oil

Pregabalin (PGB) drug abuse is common among the youth. It substituted tramadol before its recent schedule as a controlled drug since April 2019. PGB is an antiepileptic drug acting on the central nervous system. It blocks calcium channels regulating the action of neurotransmitters and causing prolonged depolarization. The present study aimed to investigate the toxic effect of long term pregabalin abuse on the reproductive function and body weight in both male and female albino rats and to evaluate the ameliorative effect of wheat germ oil (WGO). Forty-eight rats were randomly divided into eight groups. The first four groups were males and they were treated as follows: control group (1.5 mL saline), WGO group (1.5 mL L/kg), PGB group (300 mg/kg), and protective group (PGB + WGO). All doses were administrated once per day for 60 days by gastric gavage. The second four groups were females. They were divided and treated the same as the male groups. Pregabalin caused significant weight loss, decreased serum triglyceride level, and increased leptin gene expression in all rats. PGB affected male rats reproduction by decreasing total testosterone serum level and inhibiting spermatogenesis. Reproductive toxicity in females was caused by decreasing pituitary steroids, increasing gonadal hormones, and increasing the number of atretic ovarian follicles. Mechanism of toxicity may be attributed to the PGB oxidative stress effect that induced apoptosis and caused diffuse gonadal atrophy. WGO showed a protective effect on PGB induced toxicity as all measured parameters were relatively improved.

Comparison of Efficacy and Safety of Patient Taking Pregabalin and Desvenlafaxine in Neuropathic Pain

To compare safety and efficacy of pregabalin and desvenlafaxine respectively for treating Neuropathic Pain. 04 patients were entered into a prospective observational study of pregabalin and desvenlafaxine in neuropathic pain for 6 months. Patients were randomly arranged into 2 groups, 52 patients received pregabalin and other group of 52 patients received desvenlafaxine. The initialassessement were made during the first visit and two subsequent reviews were done in 2 months interval, up to 6 months. Visual analogue pain scores, incidence of side effects were measured. The pain scores(mean±S.D.) were 5.37±1.14 and 6.7±1.39 respectively for desvenlafaxine and pregabalin.The low pain score of desvenlafaxine was associated with prolonged pain relief. There were pronounced differences in incidence of side effect between the two drugs: pregabalin, 36.5% compared to desvenlafaxine, 7%. The study findings revealed that desvenlafaxine is more safe and efficacious than pregabalin. Thus this study recommends the use of desvenlafaxine for neuropathic pain over pregabalin

Retinal teratogenicity of pregabalin in chick embryo model

Background Pregabalin is a gamma-aminobutyric acid analog that binds to the α2-δ subunits of the pre-synaptic voltage-dependent calcium channels of nerves with a high affinity and selectivity. In this study, the retinal teratogenic potential of pregabalin was investigated in a chick embryo model. Materials and methods Fertilised chicken eggs were divided into groups for administration with different doses of pregabalin. All eggs were opened on the 10th day of incubation. The embryos were dissected and the effects of pregabalin on the retina were investigated histopathologically, morphometrically, and immunohistochemically (Caspase-3). Results There was no statistically significant difference between the low dose pregabalin, control, or vehicle control groups in terms of the number of retina layers and retinal thickness. Medium and high dose pregabalin caused a statistically significant decrease in the number of retina layers, as well as sensory retinal and pigment epithelium layer thicknesses. The outer nuclear and outer plexiform layer did not form in the group administered a medium dose. Similarly, the outer nuclear, outer plexiform, inner nuclear, and inner plexiform layer did not form in the high-dose group. No statistically significant difference was observed between the groups in terms of cellular damage and Caspase-3 expression. Conclusion The use of pregabalin during pregnancy compromises retinal development in a dose-dependent manner. The use of pregabalin in pregnancy causes the aforementioned defects in this system and it may have developmental effects that needs to be further evaluated.