Neurológia pre prax 5/2016

Use of pregabalin in clinical practice

Pain in diabetic polyneuropathy is a pharmacologically difficult-to-manage condition that tends to be resistant to treatment with both non-steroidal anti-inflammatory drugs and common analgesics. Antidepressants and antiepileptics are the first-choice drugs. Pregabalin is an antiepileptic drug derived from gabapentin that has been shown to reduce the intensity of neuropathic pain (Richter et al., 2005). It is a structural lipophilic GABA analogue, which readily crosses the blood-brain barrier. The mechanism of action likely involves an ability to bind to the α2 δ-subunit of a voltage-gated presynaptic calcium channel, by which pregabalin reduces the release of excitatory calcium into the cell. It is usually administered twice or three times daily at a total daily dose of 150–600 mg. It is generally well tolerated, with the most common adverse effects being vertigo, somnolence, and peripheral oedema.

Keywords: pregabalin, gabapentin, neuropathic pain, diabetic neuropathy, anxiety disorder