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Re: Pregabalin vs gabapentin

Posted by ed_uk2010 on January 29, 2015, at 10:27:50

In reply to Pregabalin - does it cause brain damage?, posted by zonked on January 28, 2015, at 23:50:25

>Gabapentin apparently prevents new synapse formation, I've learned in the last year.
> Won't touch the crap with a ten foot pole. Being a chemical cousin, does anyone know if Pregabalin (Lyrica) does the same thing?

Pregabalin and gabapentin act at the same receptor, but pregabalin is more bioavailable and more potent. Whatever effect gabapentin has on synapse formation, pregabalin probably exerts a more powerful effect.

I don't think it's entirely clear what the long-term effect of these drugs is on the adult brain. New synapses *are* formed in the adult brain, particularly after injury, but far less than are formed during development. The effect of these drugs during pregnancy clearly needs a lot of research.... they cross the placenta into the fetus.

It's possible that the synaptic effects of these drugs (often called gabapentinoids) leads to memory and cognitive impairment. Other psychiatric drugs substantially implicated in cognitive impairment are benzodiazepines and those drugs with antimuscarinic effects (acetylcholine blocking properties) eg. tricyclic antidepressants and many antipsychotics. SSRIs and SNRIs are not antimuscarinic.

With all of the above, elderly people are much more susceptible to cognitive/memory impairment and confusion.

Whether gabapentin and pregabalin are safer or less safe for cognitive function than benzos I don't know. Benzodiazepines have a particular effect on memory ie. they reduce the ability to form detailed new memories. High doses may cause considerable amnesia in some people.




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