01 · How it works
Origins & Mechanism
Pregabalin binds the alpha-2-delta subunit of voltage-gated calcium channels and reduces release of excitatory neurotransmitters. It does not directly activate GABA receptors.
02 · Immediate effects
Recognize the effects
Signs of Use
- Uncoordinated, drunken gait
- Myoclonic jerks and muscle twitches
- Double vision
- Swelling of hands or feet
- Slurred speech and sedation
Short Term
- Dizziness and vertigo
- Talkativeness and euphoria
- Loss of balance
- Deep sleep
- Synergistic respiratory depression with opioids or alcohol
Long Term
- Physical dependence and withdrawal
- Insomnia, sweating, and seizures after abrupt cessation
- Weight gain and edema
- Cognitive slowing
- Depressive symptoms
03 · Long-term consequences
Sedation and respiratory depression
Pregabalin toxicity is especially dangerous with opioids, alcohol, or other central nervous system depressants.
Medical emergency
Identifying an emergency
Seizures, deep coma, abnormal heart rhythm, or respiratory failure require 911.
Emergency: Naloxone does not reverse pregabalin itself