Gabapentin and pregabalin are often used as alternatives to opioid analgesics to treat chronic pain. How is that working? Find out what you know.
Pregabalin and gabapentin are both FDA-approved for the treatment of several pain conditions. Both have become more popular for pain management lately given the expanding restrictions on opioid prescribing. However, there has been limited research on which is more effective and which is safer. Click through our 10 question quiz to see just how much you know about these two treatments.
Question 1. True or false? Pregabalin and gabapentin are similar with regard to their chemical structures and effects on the nervous system.
Answer: A. True. Pregabalin and gabapentin are gabapentinoids and appear to primarily exert their effects by acting on calcium channels, although additional actions may be involved in their analgesic effects.1
Answer: F. A and D. Gabapentin was initially approved for treatment of seizures, followed by approval for treatment of postherpetic neuralgia. Pregabalin was first approved for treatment of pain from diabetic peripheral neuropathy (DPN) and postherpetic neuralgia, followed by labeling for treatment of fibromyalgia, neuropathic pain associated with spinal cord injuries, and seizures.2
Answer: D. 25 million. In 2016, gabapentin was the 10th most commonly prescribed medication in the US.2
Answer: B. False. In 2016, Lyrica-the only branded pregabalin available-ranked 8th in invoice drug spending – that is not including rebates and discounts.2
Question 5. In a recent study comparing pregabalin to gabapentin for the management of chronic sciatica, which one was found to be more effective in reducing pain?
Answer: C. Both were effective. Gabapentin and pregabalin were significantly effective in reducing pain, however, gabapentin had fewer and less severe adverse events vs pregabalin.3
Question 6. In the same study, which of the above were found to be the most common adverse events for both pregabalin and gabapentin?
Answer: F. A, B, and C. A total of 38 adverse events were reported in 67% of patients with the most common overall being dizziness (13%), drowsiness (13%), and nausea (11%).3
Question 7. Based on current research with regard to potential risk for abuse and addiction, which of the above statements appears to be true?
Answer: A. Pregabalin has a greater risk for abuse and addiction. However, for both medications the risk for abuse and addiction appears to be relatively low.4
Question 8. Which of the above appear/s to be risk factors for abusing or becoming addicted to pregabalin or gabapentin?
Answer: E. B and C. A history of substance use disorders, especially of opioids, or a history of a mental disorder appear to be risk factors for abusing or becoming addicted to pregabalin or gabapentin.1,4
Question 9. True or false? Overdoses of gabapentin are more likely to be lethal vs those of pregabalin.
Question 10. True or false? Pregabalin and gabapentin can cause withdrawal symptoms, therefore, tapering of dosage is recommended.
Answer: A. True. Pregabalin and gabapentin can cause withdrawal symptoms so tapering of dosage is recommended.1,4
1. World Health Organization. Critical review report: Pregabalin. Report presented at 41st Expert Committee on Drug Dependence Meeting; November 2018; Geneva, Switzerland.
2. Goodman CW, Brett AS. Gabapentin and pregabalin for pain - Is increased prescribing a cause for concern? N Engl J Med. 2017;377:411-414.
3. Robertson K, Marshman LAG, Plummer D, Downs E. Effect of gabapentin vs pregabalin on pain intensity in adults with sciatica: A randomized clinical trial. JAMA Neurol. 2019;76:28-34.
4. Bonnet U, Scherbaum N. How addictive are gabapentin and pregabalin? A systematic review. Eur Neuropsychopharmacol. 2017;27:1185-1215.