Role Of Pregabalin Research Articles

Role of Pregabalin in Pre-Operative and Post-Operative Pain Management of Lower Limb Orthopedic Surgeries.

Post-operative pain after orthopedic surgery has remained a challenging problem, which prolongs hospital stay and early rehabilitation. Pregabalin comes under the class of gabapentinoids that have been used in postoperative pain in arthroplasty and spine surgeries but studies regarding its role as pre-emptive analgesia in orthopedic limb surgeries are very few. To compare the efficacy of pre-operative pregabalin with a placebo drug in early post-operative pain management for lower limb orthopedics surgeries. A randomized double blinded prospective study was undertaken. Sixty patients were enrolled with age between 18 and 70 years and were divided into 2 groups. Group A - received 150 mg of oral pregabalin capsule, and Group B - received matched color empty capsules. Standard spinal anesthesia was given. Breakthrough analgesia was given with an injection of tramadol 50 mg intravenous. Assessment of pain was done with a Visual Analog Scale (VAS) at 6, 12, 24, and 48 h. In comparison to Group B, Group A had a significantly lower postoperative VAS score and required much less breakthrough analgesia within the 1st 24 h after surgery. In orthopedic lower limb fracture surgeries, pre-emptive pregabalin of 150 mg provides adequate postoperative analgesia with relatively few unfavorable side effects.

Major depressive disorder with anxious features - the role of pregabalin

IntroductionPatients with unipolar major depression often present with symptoms of anxiety. Presentations with high levels of anxiety, restlessness, and somatic correlates of anxiety can be clinically identified as anxious depression. The comorbidity of anxious and depressive symptoms is a marker of poor prognosis, with greater risk of relapse and increased suicidal risk.ObjectivesBrief review of the role of pregabalin in the treatment of major depressive disorder (MDD), based on a case study.MethodsConsultation of the clinical record and brief review of the literature on this subject.ResultsWe present the case of a 25-year-old woman, with no past psychiatric history, admitted to a psychiatric consultation with depressive symptoms, and marked anxiety and somatic complaints, such as restlessness, palpitations, gastrointestinal discomfort. She fulfilled diagnostic criteria for Major depressive disorder (MDD), and was initially treated with sertraline 50 mg, with partial response, but maintenance of prominent anxious symptoms with important functional impairment. Then, we raised the dose of sertraline to 100 mg and added pregabalin 50 mg, with up-titration to 150 mg per day, divided in three doses. We observed rapid response, particularly on the anxious symptoms, and subsequently on the patient functionality.The anxiety symptoms can increase in the first days of treatment with a selective serotonin reuptake inhibitor, which is the first-line therapy for major depression. Those are particularly difficult to treat, resulting often in treatment resistance and functional impairment. Pregabalin has a proven rapid-onset anxiolytic effect, with less cognitive and motor effects and less risk for dependence than benzodiazepines. It has demonstrated efficacy for the treatment of generalized anxiety disorder, but the use for patients with MDD has not been clearly studied.ConclusionsAlthough the evidence on this subject is sparse, pregabalin augmentation of antidepressants could be an adequate option for the treatment of depression, allowing a faster action on the anxiety symptoms, especially on the first weeks of treatment, without some of the risks of the benzodiazepines.Disclosure of InterestNone Declared

Role of Pregabalin in Reducing Postoperative Analgesic Requirement of Patients Undergoing Knee Arthroscopy Anterior Cruciate Ligament Repair

Objective: To assess the effect of pregabalin in reducing the postoperative requirement of analgesics of patient undergoing knee arthroscopic anterior cruciate ligament repair surgery. Study Design: Prospective randomized control trial. Place and Duration of Study: Department of Anesthesia, Ghurki Trust Teaching Hospital Lahore from 1st June 2021 to 31st December 2021. Methodology: Eighty patients were randomly divided into two groups; group A and group B, each group comprised 40. Group A receive placebo and group B receive pregabalin 150mg once a day for two days after surgery. Pain assessment done with the help of Numeric Rating Scale and rescue analgesia was recorded. Results: The mean age was 31±10.2 years of group A and 33±10.3 year of Group B. There were more males within both groups in comparison to females with a percentage of 77.5% and 85% respectively. The reduction was seen within Group B in comparison of Group A in terms of ASA class, VNRS, and maximum sensory block. Cumulative volume of PCA in ml was also less in group B than group A with a significant difference within 0-6 hours. Conclusions: The use of pregabalin 150mg after surgery for two days significantly reduces the analgesic consumption Keywords: Pregabalin, Postoperative analgesic, Numeric rating scale

The role of pregabalin in neuropathic pain management in cancer patients

Despite the wide availability of analgesics for prescription in cancer pain, including both opioid and non-opioid medications, population studies have for many years demonstrated unadvisable pain management. International analyses indicate inadequate use of opioid and adjuvant drugs per capita. At the same time, patients complain about the accompanying pain, not treated effectively, especially in the course of cancer. One of the many causes of cancer pain that is difficult to treat is the co-occurrence of neuropathic pain. The article presents contemporary views on the treatment of neuropathic pain associated with cancer, including the site of application of gabapentinoids in the treatment scheme.

Pregabalin inhibits in vivo and in vitro cytokine secretion and attenuates spleen inflammation in Lipopolysaccharide/Concanavalin A -induced murine models of inflammation

Immune system alteration has been implicated in the pathogenesis of chronic pain conditions, epilepsy and generalized anxiety disorder. Targeting cytokines has recently been proposed for the management of such conditions. Pregabalin (PGB) is an antiepileptic agent used for the management of these conditions. However, little is known about its immunomodulatory effects on cytokine secretion in vivo and in vitro. Hence, a mitogen (Lipopolysaccharide [LPS] or Concanavalin A [ConA])-induced murine model of inflammation was used to investigate the effect of PGB on in vivo and in vitro IL-1β, IL-6, TNF-α and IL-2 cytokine secretion using ELISA. In addition, PGB effect on spleen histology, as a lymphoid organ, was examined. Our results revealed that PGB significantly inhibited the secretion of ConA-induced IL-6 secretion, basal and ConA-induced TNF-α and IL-2 secretion in splenocytes in vitro. In vivo, PGB inhibited basal and LPS/ConA-induced IL-6 and TNF-α secretion in addition to LPS-induced IL-1β and ConA-induced IL-2 secretion. Moreover, PGB attenuated mitogen-induced inflammatory changes in the spleen. These findings provide an evidence of the anti-inflammatory properties of PGB on cytokine secretion and lymphoid organ inflammation. This might give insights into the role of PGB in the management of the inflammatory state in PGB-indicated conditions.

Role of Pregabalin in Treatment of Polyneuropathy in Multiple Myeloma Patients: A Retrospective Study.

Polyneuropathy (PN) is a frequent and significant clinical manifestation of multiple myeloma that may be observed at onset of disease or induced during treatment as a therapy-related complication. Polyneuropathy may be a relevant issue in myeloma patients owing to its significant impact on the quality of life, considering that it may lead to dose reduction or treatment discontinuation. The present retrospective study intended to evaluate efficacy of pregabalin (PGB) in treatment of PN in multiple myeloma patients. Medical charts of 108 consecutive PN myeloma patients were reviewed. Data regarding the tumor history and therapy as well as the clinical and neurophysiological examinations 6 months before and after initiation of PGB therapy were collected. Thirty-eight medical charts had all the requested information. All patients (n = 38) underwent bortezomib-based treatment; 19 were previously treated and 19 were treatment naive. At first neurologic visit, all patients had PN symptoms (grade 2 of National Cancer Institute-Common Toxicity Criteria) without relevant pain. Neurophysiological evaluation showed a significant decrease in sensory nerve action potential amplitude (P = 0.006), conduction velocity (P = 0.006), and distal latency (P = 0.03) of sensory nerves between the first and the last neurological examination, in all patient population. Similar results were observed in treatment-naive patients, when the study cohort was stratified according to previous treatment. On the contrary, no significant differences were found between the first and the last neurophysiological follow-up evaluation in previously treated patients. Six months after PGB treatment, all patients reported disappearance of neurological symptoms (grade 0 National Cancer Institute-Common Toxicity Criteria). In this retrospective study, improvement in neurological symptoms during PGB therapy was observed in the total population, despite the presence of a distal, sensory axonal neuropathy, as evidenced by neurophysiological examination.

Effects of a single dose of preoperative pregabalin and gabapentin for acute postoperative pain: a network meta-analysis of randomized controlled trials.

BackgroundPregabalin (PGB) and gabapentin (GBP) are current and emerging drugs in the field of pre-emptive preoperative analgesia. However, the role of PGB or GBP in acute postoperative pain management still remains elusive.Materials and methodsWe conducted a comprehensive literature search of articles published by December 3, 2017. A total of 79 randomized controlled trials with 6,201 patients receiving single-dose premedication were included. Through a network meta-analysis (NMA), we validated the analgesic effect and incidence of adverse events by using various doses of PGB or GBP administration.ResultsNMA results suggested that the analgesic effect may be dose related. For 24-hour opioid consumption, a consistent decrease was found with the increase in the dose of PGB or GBP. For 24-hour pain score at rest, a high dose (≥150 mg) of PGB was more effective in decreasing pain score than a dose of 75 mg, and a high dose (≥900 mg) of GBP reduced pain intensity than doses of 300 or 600 mg. Moreover, the incidence of adverse reactions varied with varying doses of PGB or GBP.ConclusionA dose–response relationship was detected in opioid consumption and postoperative pain for a single-dose preoperative administration of PGB and GBP. Making reasonable choice of drugs and dosage may prevent the occurrence of adverse reactions.

Role of Pregabalin in Management of Pruritus: A Literature Review.

Pruritus can be one of the distressing symptoms of many dermatologic, systemic, neurologic or psychiatric disorders. In each case, the origin of itch is in the skin and/or the nervous system. Involvement of the nervous system causes neurogenic, psychogenic or neuropathic itch. Itch sensation is transferred to the central nervous system via unmyelinated C-type nerve fibers, and many mediators and receptors engage in the its induction and transmission. Also it has been demonstrated that there are similarities and interactions between neurotransmitters and pathways of pain and itch sensation. Hence, effective drugs in reducing the neuropathic pain such as pregabalin have been studied and used in the management of different itchy conditions. In this narrative review we considered the available published papers dealing with the antipruritic effects of pregabalin. Results of studies conducted in uremic patients show that pregabalin is an effective option in reducing uremic pruritus especially in those who have not responded to antihistamines and topical moisturizers. Data about the effects of pregabalin on other itchy conditions are very limited; however results of the available studies show beneficial effects of this drug in burn patients with more than 5% involvement of the total body surface area, in prurigo nodularis, and in chronic and idiopathic itch. One considerable issue is that the therapeutic effects of pregabalin on uremic pruritus and post burn itch may appear more rapidly than its effects in the other conditions (1-2 weeks vs > 4 weeks). The most reported adverse effects of pregabalin are sedation, dizziness and drowsiness. Whether pregablin can be unequivocally considered as an effective and reasonable choice in the management of pruritus with different causes is a question that should be answered through large scale randomized controlled studies.

Guidelines in the management of diabetic nerve pain: clinical utility of pregabalin.

Diabetic peripheral neuropathy is a common complication of diabetes. It presents as a variety of syndromes for which there is no universally accepted unique classification. Sensorimotor polyneuropathy is the most common type, affecting about 30% of diabetic patients in hospital care and 25% of those in the community. Pain is the reason for 40% of patient visits in a primary care setting, and about 20% of these have had pain for greater than 6 months. Chronic pain may be nociceptive, which occurs as a result of disease or damage to tissue with no abnormality in the nervous system. In contrast, neuropathic pain is defined as “pain arising as a direct consequence of a lesion or disease affecting the somatosensory system.” Persistent neuropathic pain interferes significantly with quality of life, impairing sleep and recreation; it also significantly impacts emotional well-being, and is associated with depression, anxiety, and noncompliance with treatment. Painful diabetic peripheral neuropathy is a difficult-to-manage clinical problem, and patients with this condition are more apt to seek medical attention than those with other types of diabetic neuropathy. Early recognition of psychological problems is critical to the management of pain, and physicians need to go beyond the management of pain per se if they are to achieve success. This evidence-based review of the assessment of the patient with pain in diabetes addresses the state-of-the-art management of pain, recognizing all the conditions that produce pain in diabetes and the evidence in support of a variety of treatments currently available. A search of the full Medline database for the last 10 years was conducted in August 2012 using the terms painful diabetic peripheral neuropathy, painful diabetic peripheral polyneuropathy, painful diabetic neuropathy and pain in diabetes. In addition, recent reviews addressing this issue were adopted as necessary. In particular, reports from the American Academy of Neurology and the Toronto Consensus Panel on Diabetic Neuropathy were included. Unfortunately, the results of evidence-based studies do not necessarily take into account the presence of comorbidities, the cost of treatment, or the role of third-party payers in decision-making. Thus, this review attempts to give a more balanced view of the management of pain in the diabetic patient with neuropathy and in particular the role of pregabalin.

P-511 - Role of pregabalin in treatment of patients with depression and pain comorbidity

Pregabalin is an anticonvulsant drug used for neuropathic pain and as an adjunct therapy for partial seizures with or without secondary generalization in adults. It has also been found effective for generalized anxiety disorder and is approved for this use in the European Union. Aims To identify the efficacy of the treatment with Pregabalin in patients with chronic pain associated to comorbilidad with depression. Methods Descriptive study of a sample of patients with depression and chronic pain admitted in Clinica Doctor Cano (Salobrena- Granada, Spain) between January 2010 and January 2011, with data of the clinical histories: age, sex, psychiatric and illness comorbidity, socio-demographic variables, and hospitalization. All the patients received antidepressing treatment with an SSRIs (serotonin-specific reuptake inhibitor) in a time not superior to four weeks, associated with a benzodiazepine of low power (lorazepam). We added Pregabalin to an rising dose of 75–150 mg per day. Results 70% are women. We observe decrease of the perception of the pain in 75% of patients. The patients who answered better to the antidepressing treatment (valued with scale HAM-Depression) obtained better response with Pregabalin on the chronic pain. Conclusion It is important to determine the association between chronic pain and depression for to improve the efficacy of therapeutic approaches. Pregabalin can be useful in a a sample of patients with this comorbidity.

A study on efficacy of Pregabalin in acute Herpetic Neuralgia.

Herpes zoster is an intractable painful condition. The pain during first thirty days of onset is known as acute herpetic neuralgia. Multiple treatments using NSAIDS, opioids and tricyclic antidepressants are available but the role of pregabalin in acute Herpetic Neuralgia is not assessed in any of Indian studies. This study was aimed to determine efficacy and safety of Pregabalin in reducing pain of acute Herpetic Neuralgia. In this placebo-controlled 4 week trial including 45 subjects, 23 patients received Pregabalin in the dosage of 150 mg/day in divided doses and 22 patients received placebo within 72 hours of onset of Herpes zoster. Subjects receiving Pregabalin had a statistically significant reduction (p<0.0001) in visual analogue scale(VAS) score as compared to placebo, indicating the efficacy of Pregabalin in the treatment of acute pain associated with Herpes zoster. Side effects most commonly noted were somnolence and dizziness. The results of this study indicate that Pregabalin is effective in relieving pain of acute Herpetic Neuralgia.

Pregabalin in acute and chronic pain

Pregabalin is a gamma-amino-butyric acid analog shown to be effective in several models of neuropathic pain, incisional injury, and inflammatory injury. In this review, the role of pregabalin in acute postoperative pain and in chronic pain syndromes has been discussed. Multimodal perioperative analgesia with the use of gabapentinoids has become common. Based on available evidence from randomized controlled trials and meta-analysis, the perioperative administration of pregabalin reduces opioid consumption and opioid-related adverse effects in the first 24 h following surgery. Postoperative pain intensity is however not consistently reduced by pregabalin. Adverse effects like visual disturbance, sedation, dizziness, and headache are associated with higher doses. The advantage of the perioperative use of pregabalin is so far limited to laparoscopic, gynecological, and daycare surgeries which are not very painful. The role of the perioperative administration of pregabalin in preventing chronic pain following surgery, its efficacy in more painful surgeries and surgeries done under regional anesthesia, and the optimal dosage and duration of perioperative pregabalin need to be studied. The efficacy of pregabalin in chronic pain conditions like painful diabetic neuropathy, postherpetic neuralgia, central neuropathic pain, and fibromyalgia has been demonstrated.

Pregabalin for the treatment of postsurgical pain

Importance of the field: Multimodal postoperative pain management targeted at diminishing harmful outcomes should include pregabalin in cases that need opioid reduction and when the risk of developing chronic neuropathic postsurgical pain is present. Gabapentanoids have grown in importance due to their opioid-sparing effects. They may also contribute to the prevention of chronic postsurgical pain.Areas covered in this review: We reviewed the literature regarding the use of gabapentanoids and their role in treatment modalities in acute postsurgical pain. Dosing, therapeutic efficacy, side effects, and their role within a multimodal regimen are discussed. Particular emphasis is placed on their ability to provide an opioid-sparing effect, as well as on their potential for inhibiting chronic neuropathic pain. A Pubmed search of pregabalin, gabapentin, acute pain, multimodal analgesia, chronic postsurgical pain, and neuropathic pain between 2000 and 2010 was done. Relevant articles – including randomized controlled trials, retrospective trials, case series, case reports, and review articles – were filtered to include those that relate to postsurgical pain.What the reader will gain: Readers will gain an increased appreciation of the role of pregabalin in postsurgical pain in patients at risk of developing chronic pain.Take home message: Pregabalin is a safe and effective medication that may decrease perioperative opioid use in patients with more acute neuropathic pain than acute inflammatory pain. When surgery involves more neuropathic-type acute pain there is growing evidence that pregabalin may decrease the incidence of chronic pain.

Tvilsom dokumentasjon av effekten av pregabalin ved fibromyalgi

Use of Pregabalin has increased considerably in Norway during the last years. One explanation is prescription to patients with diffuse musculo-skeletal pain. The aim of the article is to clarify the effect of pregabalin in fibromyalgia. This article is based on literature identified through searches in Medline and public trial registries. Six randomized, double-blind clinical trials were identified (three of them in peer-reviewed journals) and Pfizer had initiated and sponsored them all. The three trials published in peer-reviewed journals used a numerical rating scale for pain as the primary endpoint, and all trials reported statistically significant improvements on mean pain scores in relation to placebo. The mean pain reduction was between 9 % and 15 %. Effects on secondary endpoints varied considerably, both within and between the studies. Negative results were seldom mentioned in the abstracts, and secondary endpoints were reported incompletely. All 19 reviews referred to one or more of the clinical trials, and were generally limited to describing main results. Recommendations for pregabalin in treatment of patients with fibromyalgia are based on rather weak evidence. Until trials independent of industry-funding are published, the role of pregabalin in treatment of fibromyalgia remains unclear.

Pregabalin (PGB) in treatment of oxaliplatin-induced neuropathy

e15045 Background: Oxaliplatin is effective in many GI cancers, especially colorectal cancer (CRC); however, severe neuropathy develops frequently. PGB is a new antiepileptic drug approved as adjunctive therapy of partial seizures in adults, pain from diabetic neuropathy and post-herpetic neuralgia. PGB is structurally related to gabapentin, but unlike gabapentin, it is well absorbed (&gt; 90%) and its absorption is dose independent. In this study, we evaluated the role of PGB in reduction of oxaliplatin- induced neuropathy. Methods: From Nov 2006 to Dec 2008, a total of 23 pts (age range: 50–71 yrs; M:F = 14:9) with GI cancers were treated with PGB upon development of oxaliplatin-induced neuropathy &gt; G2 (NCI-CTC 3.0). Of these pts, 15 received FOLFOX for CRC, 2 EOX for gastric ca and 6 GemOx for pancreatic ca. Neurologic symptoms were evaluated prior PGB and then q 2 wks. PGB was started at 50mg PO tid, and if tolerated, dose was escalated by 50mg increments until symptoms improved up to a maximum of 150mg PO tid. Results: 5/23 pts (22%) were escalated to 150mg PO tid. 12 pts (52%) were escalated to 100mg tid, out of which 7 (58%) continued, 4 (33%) stopped due to no benefit and 1 (8%) stopped due to weight gain. 1/23 (4%) decided to follow 100mg bid. 5/23 (22%) could not be escalated above 50mg tid; 2 continued at this dose and 3 stopped due to CNS side effects. Onset of benefit was observed in 2 - 6 wks. In 3/23 pts (13%), neuropathy improved from G3 to G2, 2/23 (9%) from G3 to G1, 5/23 (22%) from G2 to G1, 6/23 (26%) remained stable at G2 and no pts remained at G3. Most pts continued PGB even beyond disease progression on oxaliplatin (15/23). Among those who continued (15), duration of therapy was 4 -24 months. The best benefit with PGB was seen at a dose of 150mg tid, followed by 100mg tid. The most common non-hematologic toxicities were dizziness (57%), headache (26%), somnolence (22%), dry mouth (17%), ataxia (17%), tremor (13%), peripheral edema (13%), weight gain (13%), blurred vision (13%) and constipation (9%). Hematologic toxicity (G1 thrombocytopenia) was seen in 1 pt (4%) but impact of chemotherapy could not be excluded. Conclusions: PGB significantly reduces the severity of oxaliplatin-induced neuropathy. Larger, placebo-controlled trials assessing safety and efficacy of oral PGB are warranted in pts treated with oxaliplatin. [Table: see text]

Pregabalin for fibromyalgia: Some relief but no cure

What is the role of pregabalin (Lyrica) in the treatment of fibromyalgia? In this article the authors explore the putative pathophysiology of fibromyalgia, pregabalin's mechanism of action and evidence of efficacy, and its emerging role in treating this challenging disease.

Does Pregabalin Have Neuropsychotropic Effects?: A Short Perspective

Pregabalin is a newly developed synthetic gamma-aminobutyric acid (GABA) that is approved for the treatment of fibromyalgia and several neuropathy. It has been proven to show analgesic, anxiolytic, anticonvulsant and sleep enhancement effects, which could be applicable in the treatment of a variety of psychiatric disorders. There have been consistent reports that unexplained somatic symptoms (i.e., pain) may be a part of psychiatric disorders such as major depressive disorder (MDD) and anxiety disorders. Previous researches have also suggested the possible therapeutic potential of anticonvulsants as augmentation therapy or monotherapy in the treatment of mood disorders and anxiety disorders. Hence this short perspective tries to prompt and facilitate a shifting of researchers' attention to potential neuropsychotropic drug role of pregabalin to treat a wide range of neuropsychiatric disorders.

Potential role of pregabalin in the treatment of lithium-induced tremor: a case report

Pregabalin is a structural analogue of gamma-aminobutyric acid (GABA), one of the key inhibitory neurotransmitters in the brain. It is approved by the United States Food and Drug Administration (FDA) for the treatment of pain related to diabetic peripheral neuropathy, post-herpetic neuralgia, adjuctive therapy for partial onset seizures, and fibromyalgia (US FDA, 2007). Pregabalin has also shown efficacy in other conditions for which it is used off-label, including anxiety (Feltner et al. , 2008). The current report describes the first documentation of the usefulness of pregabalin in treating lithium-induced tremor. In the case described, pregabalin was prescribed as an anxiolytic to an in-patient with treatment-refractory major depressive disorder and generalized anxiety disorder; the beneficial effect on tremor was coincidental and unexpected. However, a pilot randomized, double-blind, placebo-controlled clinical trial demonstrated the efficacy of pregabalin in the treatment of benign essential tremor (Zesiewicz et al. , 2007) and a large multicentre trial (clinicaltrials.gov NCT00584376) is currently in process to evaluate its efficacy and safety for this indication. It is plausible that pregabalin may therefore have a unique role in the treatment of patients with lithium-induced tremor, particularly considering the frequent comorbidities of anxiety in patients treated with lithium (bipolar and major depressive patients). To our knowledge, there have been no published case reports of the use of pregabalin for lithium-induced tremor. Mr A was a 65-yr-old man with a history of major depressive disorder and generalized anxiety …

Role of pregabalin in the treatment of generalized anxiety disorder

Generalized anxiety disorder (GAD) is a common, typically persistent, and disabling condition that is often not recognised, or treated in an evidence-based manner. Current pharmacological and psychological treatment approaches have a number of drawbacks, including a delay in onset of clinical effect, varying relative efficacy against psychological or somatic symptoms of anxiety, potentially troublesome adverse effects, and discontinuation symptoms on stopping treatment. Pregabalin is a structural analog of the inhibitory neurotransmitter gamma amino butyric acid (GABA) but is thought to exert its anxiolytic effects through binding in a state-dependent manner to the alpha-2-delta sub-unit of voltage-gated calcium channels in "over-excited" pre-synaptic neurones, reducing release of excitatory neurotransmitters such as glutamate and substance P. At fixed doses of 200 mg/day or greater, it has consistent proven efficacy in acute treatment of DSM-IV-defined GAD, with some evidence of an early onset of clinical effect, and of efficacy across psychological and somatic anxiety symptom clusters. A pregabalin dosage of 450 mg/day is efficacious in the prevention of relapse. There is at present no published direct comparison with an SSRI. The current known adverse effect profile and studies in healthy volunteers together suggest that pregabalin may have some tolerability advantages over benzodiazepines and venlafaxine, at least in short-term treatment.