Managing CRPS - comparing two related painkillers - Neurontin and Lyrica

This article is worth reading as it is very thorough. Rather than repeating material that is much more authoritatively presented by others, we will just choose certain difficult or controversial topics to discuss in each section.

Selected drugs

Gabapentin (Neurontin) and Pregabalin (Lyrica)

1. Gabapentin and pregabalin are the chemical names which stay the same wherever the drugs are manufactured and Neurontin and Lyrica are Trade names that may vary from country to country.

2. What the manufacturer of pregabalin says -

• Common questions
• Safety information

3. Comparing gabapentin and pregabalin - Here is a brief summary of key points taken from this article -

• Gabapentin and pregabalin have similar chemical structures. They both act to reduce overactive pain pathways.
• Neither was developed for CRPS. Pregabalin was originally developed to treat the residual pain of shingles (herpes) and the nerve pain one can get with diabetes. Gabapentin was originally developed as an anti-epileptic.
• Gabapentin appears to be safe but does not work for everyone and can have troublesome side effects. It is usually taken three times a day.
• Pregabalin seems to be more effective at relieving pain. It also seems to have a positive effect on mood and sleep. It is longer lasting and can be taken twice a day.
• Pregabalin is more predictably absorbed and takes effect more quickly.
• Common side effects of both include sedation and dizziness. Less common is weight gain and leg swelling.
• There is a difference between the two in the dose/side effects ratio. Gabapentin is usually started at a low dose and then increased until it starts to take effect. Side effects may be noticeable at the low dose but may improve as the patient accommodates to the drug.

4. Here is a forum thread discussing side effects (especially weight gain) of pregabalin (Lyrica). Here is a patient database of side effects of Lyrica.

5. Here is a patient database discussing side effects of gabapentin (Neurontin)