What They Treat
| Condition | Gabapentin | Pregabalin |
|---|---|---|
| Neuropathic pain (diabetic, post-herpetic) | Yes | Yes (more evidence) |
| Epilepsy (adjunct) | Yes | Yes |
| Generalised anxiety disorder | Off-label | Licensed in UK/EU |
| Fibromyalgia | Off-label | Yes (licensed in some countries) |
| Restless legs syndrome | Off-label | Off-label |
| Alcohol withdrawal | Sometimes | Off-label |
Addiction RiskPregabalin (and to a lesser extent gabapentin) has significant misuse and dependence potential. Both are now controlled in the UK. Do not increase your dose without medical guidance. Stopping abruptly can cause seizures, anxiety, and withdrawal syndrome.
Common Side Effects
- Dizziness (very common — especially when starting)
- Sedation and cognitive slowing ('gabapentin fog')
- Weight gain
- Blurred vision
- Coordination problems / falls risk in elderly
- Peripheral oedema (ankle swelling)
Driving WarningDo not drive when first starting gabapentin or pregabalin, or after any dose increase. The sedation and dizziness can be severe enough to impair driving — this is a legal requirement in many countries.
Dosing Schedule (Gabapentin)
| Week | Dose | Timing |
|---|---|---|
| Week 1 | 300 mg | Night only |
| Week 2 | 300 mg | Twice daily |
| Week 3+ | 300 mg | Three times daily |
| Titrate if needed | Up to 3600 mg/day | In divided doses (max 1200 mg/dose) |
Is gabapentin the same as pregabalin?
They have the same mechanism of action but pregabalin has more predictable absorption, faster onset, and is more potent. Pregabalin is considered more effective for anxiety and more prone to misuse.
Why are they controlled drugs now?
After evidence of widespread misuse (especially pregabalin for recreational 'high' when combined with opioids), pregabalin became a Class C controlled drug in the UK in 2019. Gabapentin followed. This means restricted prescribing rules apply.
How do I stop gabapentin/pregabalin safely?
Taper by no more than 25% per week. Stopping abruptly can cause withdrawal: insomnia, anxiety, sweating, tremor, and in severe cases, seizures. Tell your doctor if you want to stop.
Medical Disclaimer: This page is for general education only and does not replace professional medical advice. Always consult a qualified healthcare provider.