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Pregabalin for neuropathic pain in adults

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Cochrane Review; 45 studies (11,906 participants) comparing pregabalin with placebo.

Bottom line

Moderate‐quality evidence shows oral pregabalin (300mg or 600mg daily) has important effects on pain in some people with moderate or severe neuropathic pain after shingles or due to diabetes. Low‐quality evidence suggests oral pregabalin is effective after stroke or spinal cord injury. Pregabalin appears ineffective in neuropathic pain associated with HIV. Very limited evidence is available for other forms of neuropathic pain.

Key results

For pain after shingles, 3 in 10 people had pain reduced by 50% or more with pregabalin vs. 2 in 10 with placebo. For pain caused by diabetes, 3 or 4 in 10 people had pain reduced by 50% or more with pregabalin vs. 2 or 3 in 10 with placebo. Pain was reduced by a third or more for 5 or 6 in 10 people with pregabalin vs. 4 or 5 in 10 with placebo. Pregabalin also helped people with a mixed diagnosis (mainly pain after shingles & with diabetes) & pain after stroke. No reliable evidence for other types of neuropathic pain.

Side effects were more common with pregabalin (6 in 10) vs. placebo (5 in 10). Dizziness & sleepiness occurred in about 1 to 3 in 10 people with pregabalin. Serious side effects were rare & were not different between pregabalin & placebo. About 1 in 10 people taking pregabalin stopped taking it because of side effects

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