9 replies to this topic

[protoject]

TLDR: do you find low dose pregabalin (~25 mg - 50 mg, give or take) is, day-to-day and over time, effective for anxiety without causing significant long term side effects?

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Long version:

Okay first off I wanted to say that a couple months ago I was on the hunt for medicines that increase SWS (SLOW WAVE SLEEP), I spun through a few drugs and ended up at pregabalin. I was not only taking it for sleep but also for anxiety, but, primarily sleep since my sleep loss significantly adds to my physical and mental anxiety levels.

The two other meds I tried were: trazadone and gabapentin.

Gabapentin caused too many daytime side effects and tolerance built to the point where it wasn't nearly as good for sleep.
Also trazodone could help initiate sleep but not maintain it, and also it gave me worse tachycardia than I already have.

I had no issue coming off trazadone; gabapentin was a bit harder to come off of but not impossible. Didn't take very long or cause any serious side effects. Though I believe there may have been some long term side effect that im not able to pin point.


Anyway with pregabalin, I started low, 25 mg twice a day, but then i realized it's not helping much for sleep, i boosted up to about 200, then i went above that up to about 600 or 800. I only did this for a short time as the side effects outweighed the good ones at that high dose; actually once i brought the dose down to about 300, a lot of the side effects that I got at a higher dosage, didnt even exist at the lower (such as joint and muscle pain).

So I tapered over time, got my dose down to about 150 or so.

Actually, the best dose for sleep seems to be between 100 and 200 mg.

However I took pregabalin for a month solid, maybe a week or two longer than that.

After tapering down and coming off of it i seem to be left with a worsened depression and dysthymia.

The good sides are that pregabalin helped sleep and also physical anxiety.
Bad side is that it worsened depression and dysthymia, and kinda malleated my brain to the point where cognition is worsened, and I feel that it malleated my personality or something.

However I would like to get the anti-anxiety effect again. The pregabalin helped to the point that my chronic tachycardia thats been going on for about a year, was significantly lessened. I would like to sleep however I may be able to get by on sleep without pregabalin at this point , and I have less harmful alternatives im working on.

I havent taken pregabalin for about one month, save for today. Im trying 30 mg, and will probably leave it at that.

Is there anyone here who has experience with pregabalin and different dosage levels? And out of those people, is there anyone who can say that they experienced long term side effects from higher dosing , but was able to go down to a much lower dose and receive the benefits without the long term negative side effects?

I'd really like to try the small doses maybe B.I.D. (2x a day), but I would rather not if this would extend any damages done by pregabalin. But if I can get away with it then I will cuz it beats this effin ridiculous adrenaline and tach i get for no reason whatsoever.

Edited by protoject, 13 July 2013 - 07:54 PM.

[nowayout]

Do you think the random adrenalin may be a medication withdrawal effect?

If so it may go away if you just leave it be.

I have had that coming off some stuff, I think mirtazapine on one occasion and xanax on another. It eventually went away.

I do still have the chronic anxiety I always have but these symptoms on top of it eent away with time.

[protoject]

Do you think the random adrenalin may be a medication withdrawal effect?

If so it may go away if you just leave it be.

I have had that coming off some stuff, I think mirtazapine on one occasion and xanax on another. It eventually went away.

I do still have the chronic anxiety I always have but these symptoms on top of it eent away with time.

It seemed i was getting the random adrenaline for about a year prior to this. Its frequency was once less but then became worse. Pregabalin actually helped to slow my heart rate down and lessen the physical anxiety. When I went off of it i didn't get a particular rebound anxiety, but instead, the physical adrenaline rushes have begin to come back at the same frequency they were at before taking pregabalin.... for a while they didn't come back but this week was horrible...

I just don't understand how one week I can be feeling so much better , adrenaline-rush free, and suddenly it comes back with a vengence for several days, sometimes, weeks. It seems to be related to no particular external cause nor any internal thought, it's like a snake that just comes and chokes my brain and body...

When on the pregabalin I would say it progressively got rid of the problem, and it didn't prevent it 100% of the time but it did about 75% of the time which is pretty good, and the attacks were mainly abated after that for about a month, except intermittently for a few days here and there, and suddenly it seems to be back again....

sometimes I just wish I knew what kinds of tests to ask for at the doctor that I haven't had done, and to have a justification for this so that I dont get any flack or resistance.

Edited by protoject, 16 July 2013 - 03:57 PM.

[mrd1]

Your dose is going all over the place. Lyrica works with GABA the primary inhibitor in the brain. If your brain had breaks your going back and forth between slamming them and barely tapping them. Does your doctor know your making all these rapid changes? I like that your trying to take as little as possible. However, your brain doesn't like rapid change!

Do you think you will be able to continue it for a period of greater than 12months maybe years without dose escalation ?

[protoject]

Hey, so I tried the lower dose again , 30 mg, frankly I think pregabalin causes more problems than it's worth at this point, so I've not taken it for maybe 3 weeks total now, I have to say that it definitely has negative long term effects but that they have been gradually subsiding and I'm feeling better than when I was on it ... so I'm not sure I'd recommend it to anyone based on my personal experience, except in the case where extreme desperation from long term insomnia makes it necessary and there is no other sane option available (which was the case for me at that point)... but alas I do believe there are better options! I'll make a thread later.

Also, I think it was still a better option than Benzos, again based on personal experience, and the fact that I didn't experience worsened rebound insomnia, nor a shallowing of sleep parameters while on the drug.

Edited by protoject, 08 August 2013 - 04:09 PM.

[protoject]

I've tried it again after months of not being on it, I've been trying it with a low dose of trazodone (i use traz. for sleep initiation and pregabalin to improve sleep), for sleep it has really worked, I did find that 175-200mg is my sweet spot dose but it's a bit shifty. 200 or even 225 works a lot better than 175 but it does seem to affect me negatively during the day. Like, no motivation, kind of aloof/mentally blunted somewhat. But I didn't get that same effect at 175 mg really. I've had a flu for the past couple weeks so I'll update if there's any progress.

In terms of the previously mentioned physical anxiety, it is really helping, my heart rate is significantly down and I feel more calm.

Edited by protoject, 03 December 2013 - 05:28 AM.

[BlueCloud]

I'm also on the hunt for "safe" slow wave sleep enhancers, but the options are very limited. Have you tried cyproheptadine ( an antihistamine) ? It was hands down one of the best things for deep, restful quality sleep I've tried. My only beef with it is that it's half-life is too long, and leaves me groggy for a good part of the day after, but many people seem to find it adequate. Also, contrary to other antihistamines, this one loses a part of its effect rather quickly. To be used once or twice a week only. It's worth a shot.

Cyproheptadine also caused a significant decrease in the total waking time and increases in total non-REM sleep time, REM sleeptime, slow wave sleep, and delta activity, although no remarkable effects were observed with diphenhydramine and chlorpheniramine. In conclusion,cyproheptadine can be useful as a hypnotic, having not only sleep inducing-effects, but also sleep quantity- and quality-increasing effects.

http://www.ncbi.nlm....pubmed/17287588 ( study on rats, but seems to work on humans just fine)

Ah yes, another thing : it's effects are very delayed. It starts acting 4 hours after dosing. So plan accordingly.

Edited by BlueCloud, 03 December 2013 - 08:30 PM.

[socialpiranha]

hey proto i'm very familiar with the adrenaline serpent...i get it most when i spot someone i sort of know in a mall or basically any other social situation...but it does happen seemingly for no reason sometimes. I've tried all the gabaergics and though they do offer some help they are more trouble than they are worth. Have you tried propranolol? if it doesn't make you depressed it works quite well. Also i have found that mildronate acts as a sort of rev limiter for the heart with no noticable side effects.

[mrd1]

http://www.drugbank.ca/drugs/DB00434

lists cyproheptadine as a seritonin 2a and 2c antagonist

If I recall correctly antagonism or agonism of these receptors causes downregulation.

Could this then be used to boost the effectiveness of antidepressents without the issues of decreasing dopamine as the cost for achieving 5-ht2a and 2c antagonism via abilify or seroquel?

*** antagonism or agonism is irrelevent for 5-ht2a and 2c receptors because it has to do with total binding because it can never upregulate.

[protoject]

Hey, No I haven't tried cyproheptadine yet, but I've heard of it more than once, and recently I was thinking about it and wanted to try it. It's one of those "can't knock it till you try it" things. I think so far I've not had a great time with antihistamines which has turned me off of them, but you never know, it could work better than I had planned. I also believe I've heard about it being a 5ht2a /2c antagonist, which is also cool. I'm not sure if I should or should not worry about it downregulating those receptors with this action, as there actually are exceptions to that rule. (For example, I took eplivanserin for months and , this and also some other antagonist of 5ht2a doesn't cause downregulation, according to some studies. Though, it is an inverse agonist, not sure if that's why, but particularly it showed that these didn't downregulate the receptors). I guess my only worry is that I've also tried Ritanserin for sleep, which worked like eplivanserin, maybe even better, however it gave me panic attacks the next day (those arent something I have, usually is triggered by drugs)...not sure if this was the pro-dopaminergic effect of the 5ht2c antagonism or not... but still I'd like to give the cypro a try.

And propanolol, I've been wanting to try it as well , or even other beta blockers, except they've been noted to cause bad insomnia which is actually my worst enemy... if I could try it without that happening then maybe I'd consider...

I know polypharmacy is generally not recommended but I was also thinking that if there's a drug that I already take or have in my cabinet that could counteract the beta-blocker's insomnia effect by the time I go to bed then it might come in handy....