Yes. Pregabalin can be misused, and repeated use can lead to physical dependence and withdrawal. Research suggests misuse risk is higher among people with other substance use disorders, especially opioid use disorder, and may be greater for pregabalin than for gabapentin.
What is pregabalin?
Pregabalin is a prescription gabapentinoid used for certain neuropathic pain conditions, fibromyalgia, and as adjunctive therapy for some seizure disorders. It is a Schedule V controlled substance in the United States.
How can pregabalin be misused?
Misuse can include taking larger amounts than prescribed, using the medication without a prescription, taking it for euphoria or sedation, or combining it with other drugs to intensify effects.
Systematic reviews and pharmacovigilance studies have documented misuse and abuse involving pregabalin, particularly in people with histories of opioid or polysubstance use.
Can pregabalin cause dependence?
Yes. Physical dependence can develop with sustained exposure. Withdrawal symptoms can occur when pregabalin is abruptly stopped after regular use.
Dependence is not the same as addiction: a person can become physically dependent while taking a medication as prescribed. Addiction involves a broader pattern of compulsive use despite harm.
What can pregabalin withdrawal feel like?
Reported symptoms include insomnia, anxiety, agitation, sweating, nausea, tremor, headache, and autonomic symptoms. Severe symptoms have also been reported in case literature.
People taking pregabalin regularly should discuss any dose reduction or discontinuation with the prescribing clinician rather than stopping suddenly.
Why is pregabalin with opioids a concern?
FDA warns that gabapentinoids can contribute to serious breathing problems when used with opioids or other central nervous system depressants, especially in people with respiratory risk factors.
Studies of misuse also repeatedly identify opioid use disorder as a major risk factor for gabapentinoid misuse.
Is pregabalin more likely to be misused than gabapentin?
Several systematic reviews and observational studies suggest pregabalin may have greater misuse potential than gabapentin. One reason may be its more predictable absorption and faster onset, although misuse risk varies by person and setting.
Trinity has a separate comparison of gabapentin and pregabalin misuse and dependence risks when that article is available; until then, the drugs should be evaluated individually rather than assumed to carry identical risk.
Who may be at higher risk?
Research identifies people with opioid use disorder, other substance use disorders, psychiatric conditions, and prior medication misuse as groups in which gabapentinoid misuse is more frequently reported.
What should someone do if they are taking more pregabalin than prescribed?
Talk with a qualified clinician before making abrupt changes. If pregabalin is being combined with opioids, benzodiazepines, alcohol, or other sedatives, the risk of dangerous sedation and breathing problems can increase.
Trinity Behavioral Health provides adult detox and withdrawal-management information. This educational article does not imply that Trinity uses a specific pregabalin taper or withdrawal protocol.
Frequently asked questions
Is pregabalin a controlled substance?
Yes. Pregabalin is federally classified as a Schedule V controlled substance in the United States.
Can dependence happen when pregabalin is taken as prescribed?
Yes. Physical dependence can occur with regular prescribed use, which is why discontinuation should be medically planned.
Can pregabalin cause overdose?
Serious toxicity is more likely when pregabalin is combined with opioids or other sedatives. Breathing problems or profound sedation require emergency medical care.
Should pregabalin be stopped suddenly?
Not without medical guidance. Abrupt discontinuation can trigger withdrawal symptoms.
Sources
- Systematic Review Update: Misuse of Pregabalin and Gabapentin
- British Journal of Clinical Pharmacology: Patterns of Pregabalin and Gabapentin Misuse
- Drug Safety: Current Evidence on Gabapentinoid Misuse
- FDA: Serious Breathing Problems With Gabapentinoids
This article is general educational information and does not replace individualized medical advice.