Pregabalin Efficacy and Tolerability : A Clinical Point of View

Abstract

Objectives Antiepileptic drugs have been used in pain management since the 1960s. Pregabalin is a recently developed antiepileptic drug also used in management of chronic neuropathic pain conditions. The aim of this observational prospective study was to assess the analgesic efficacy and associated adverse events of pregabalin in treated patients with neuropathic pain. The source of medication was the free samples that have been provided by the company for evaluation. Methods Neurologists and Endocrinologists at king Hussein Medical Center prescribed Pregabalin for selected patients (no. =50) who were diagnosed to have neuropathic pain according to pre-formulated questionnaire that was developed by researchers. The majority of patients received Pregabalin 150mg as a starting dose, 300 mg as a maintenance dose for three months. then the magnitude of pain was assessed first after one week of treatment, if the patient had pain relief after one week and maintained on treatment further assessment was performed at intervals of one, two and three months. Then for each patient the average score of pain relief was calculated (0=worst value, 10=best value).patients were also encouraged to report any adverse effect during treatment period. Results A total of 50 patients with neuropathic pain were included. During the course of the study 17 patients terminated treatment during the first week (but were replaced by other 15 patients) either due to lack of efficacy (12%, n=6) or due to intolerable adverse effects (22%, n= 11). For the remaining patients the average score of pain relief was 2.8 ±1.2. The average score of pain reduction was higher among patients with diabetic neuropathy (3.4) than with other types of neuropathic pain (2.2). The most frequently reported adverse effects were dizziness, fatigue, somnolence, and gastrointestinal disturbances. Conclusion Pregabalin is effective in reducing diabetic neuropathy and to a lesser extent than other types of neuropathic pain. (But) However intolerable adverse effects still face a problem. Further studies comparing its efficacy and tolerability with other neuropathic treatment choices are needed.