Pregabalin: Safer Than Benzos?

I remember, years before approval of gabapentin, reading of the promise of the closely related drug pregabalin (Lyrica) for treatment of generalized anxiety disorder. Gabapentin beat pregabalin to market, and despite its rocky start enjoys wide use off label for treatment of anxiety.

Pregabalin, still available only as the brand, remains more costly than gabapentin which went generic years ago, but the two drugs also differ in that unlike gabapentin DEA classified pregabalin as a controlled substance, Schedule V.

Does pregabalin really have more abuse potential than gabapentin? How much less potential for development of dependence does each have relative to benzodiazepines? Can we combine them with opiates more safely, and can patients use them to treat insomnia without the parasomnias we associate with zolpidem and other hypnotics?

Have you become dependent on pregabalin or gabapentin?

Have you diagnosed patients for dependence on either drug? How will prescribing patterns change when generics hit the market?

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