Lyrica (pregabalin) vs. Klonopin (clonazepam)

• Lyrica (pregabalin) and Klonopin (clonazepam) are used to treat and prevent seizures.
• Lyrica is also used to treat neuropathic pain associated with diabetic peripheral neuropathy or postherpetic neuralgia, and fibromyalgia.
• Klonopin is also used to treat panic disorder.
• Lyrica and Klonopin belong to different drug classes. Lyrica is an anti-epileptic drug (AED) and Klonopin is a benzodiazepine.
• Side effects of Lyrica and Klonopin that are similar include dizziness, fatigue, amnesia, and confusion or disorientation.
• Side effects of Lyrica that are different from Klonopin include dry mouth, nausea, constipation, drowsiness, fluid retention (edema), blurred vision, double vision, weight gain, abnormal gait, tremor, difficulty concentrating, increased appetite, gas, myoclonus (sudden, involuntary jerking of a muscle or muscle groups), heart failure, low blood pressure, vomiting, reduced blood platelet counts, and increased blood creatinine kinase levels.
• Side effects of Klonopin that are different from Lyrica include sedation, depression, headache, weakness, unsteadiness, sleep disturbance, lack of inhibition, changes in sexual desire, rash, and irritability.
• Withdrawal symptoms may occur if you suddenly stop taking Klonopin.

Lyrica (pregabalin) is an oral medication chemically related to gabapentin (Gralise, Neurontin) used to treat pain caused by neurologic diseases such as postherpetic neuralgia as well as seizures. It also is used to treat fibromyalgia.

Klonopin (clonazepam) is a benzodiazepine type anti-anxiety medication primarily used for treating panic disorder and preventing certain types of seizures. Other benzodiazepines include diazepam (Valium), alprazolam (Xanax), lorazepam (Ativan), and flurazepam (Dalmane). Benzodiazepines act by enhancing the effects of gamma-aminobutyric acid (GABA) in the brain. GABA is a neurotransmitter (a chemical that nerve cells use to communicate with each other) that inhibits brain activity. It is believed that excessive activity in the brain may lead to anxiety or other psychiatric disorders.

Lyrica

WARNING

Antiepileptic medications have been associated with increased risk of suicidal thinking and behavior. Anyone considering the use of antiepileptic drugs must balance this risk of suicide with the clinical need. Patients who are started on therapy should be closely observed for clinical worsening, suicidal thoughts, or unusual changes in behavior.

The most common side effects of Lyrica are

• dizziness,
• drowsiness,
• dry mouth (xerostomia),
• edema (accumulation of fluid),
• blurred vision,
• double vision (diplopia),
• weight gain,
• fatigue (tiredness),
• abnormal gait (ataxia),
• tremor, and
• difficulty concentrating.

Other side effects include

• constipation,
• increased appetite,
• nausea,
• flatulence,
• amnesia,
• disorientation,
• myoclonus (sudden, involuntary jerking of a muscle or muscle groups),
• heart failure,
• low blood pressure,
• vomiting,
• reduced blood platelet counts, and
• increased blood creatinine kinase levels.

Increased creatinine kinase can be a sign of muscle injury, and in clinical trials three patients experienced rhabdomyolysis (severe muscle injury). Therefore, patients should report unexplained muscle pain, tenderness or weakness to their doctors, especially if associated with fever and malaise (reduced well-being). Lyrica has rarely been associated with angioedema (swelling of the face, tongue, lips, and gums, throat and larynx).

Klonopin

The most common side effects associated with clonazepam are sedation, which is reported in approximately half of patients. Dizziness is reported in one-third of patients.

Other common side effects include:

• A feeling of depression,
• Loss of orientation,
• Headache,
• Weakness,
• Unsteadiness, and
• Sleep disturbance
• Lack of inhibition
• Fatigue
• Amnesia
• Confusion
• Changes in sexual desire
• Rash
• Irritability

Other serious side effects of clonazepam include:

• Respiratory depression
• Fainting
• Enlarged liver
• Withdrawal symptoms (if stopped suddenly)
• Increased heart rate
• Low blood pressure
• Blood disorders

Other serious adverse reactions:

Antiepileptic medications have been associated with an increased risk of suicidal thinking and behavior. Anyone considering the use of antiepileptic drugs must balance this risk of suicide with the clinical need for the antiepileptic drug. Patients who begin antiepileptic therapy should be closely observed for clinical worsening, suicidal thoughts or unusual changes in behavior.

Lyrica

• Lyrica may be taken with or without food.
• Treating diabetic peripheral neuropathy: The initial dose for neuropathic pain associated with diabetic peripheral neuropathy is 50 mg three times a day (150 mg/day). The dose may be increased to a maximum dose of 100 mg 3 times daily (300 mg/day) after one week.
• Treating postherpetic neuralgia: The recommended dose for postherpetic neuralgia is 75-150 mg twice daily or 50-100 mg three times daily. Dosing should begin at 75 mg two times a day or 50 mg three times a day (150 mg/day). The dose may be increased to 100 mg 3 times daily (300 mg/day) after one week. If pain relief is inadequate after 2-4 weeks of treatment at 300 mg/day, the dose may be increased to 300 mg twice daily or 200 mg three times daily. Doses greater than 300 mg cause more side effects.
• Treating neuropathic pain associated with spinal cord injury: The dose for treating neuropathic pain associated with spinal cord injury is 150 to 600 mg daily. Begin dosing at 75 mg two times a day an increase to 150 mg two times daily after one week if response is inadequate. May increase to 300 mg twice daily if response is inadequate after 2 to 3 weeks.
• Treating seizures: The recommended dose for treating seizures is 150-600 mg/day divided into 2 or 3 doses, starting at 150 mg daily and increasing based on response and tolerability. The maximum dose is 600 mg/day.
• Treating fibromyalgia: Fibromyalgia is treated with 300-450 mg/day in 2 or 3 divided doses.

Klonopin

The dose of clonazepam is tailored to the patient's needs.

• For seizures in adults, the initial dose is 1.5 mg daily in 3 divided doses.
• Dosage may be increased by 0.5 to 1 mg daily every 3 days until seizures are controlled or side effects preclude further increases in dose.
• The maximum dose is 20 mg daily. The initial dose for panic disorders is 0.25 mg twice daily.
• The dose may be increased to the target dose of 1 mg daily after 3 days.

Lyrica

Alcohol and recreational drugs that cause sedation may increase the sedative effects of pregabalin.

Pioglitazone (Actos) and rosiglitazone (Avandia) cause weight gain, fluid retention, and possibly heart failure. Therefore, combining pregabalin with these drugs may increase the occurrence of weight gain and fluid retention.

Klonopin

Clonazepam, like all other benzodiazepines, accentuates the effects of other drugs that slow the brain's processes, such as alcohol, barbiturates, and narcotics and leads to increased sedation.

Lyrica

• There are no adequate studies of Lyrica in pregnant women.
• It is not known whether Lyrica is excreted in breast milk.

Klonopin

• Clonazepam and other benzodiazepines have been associated with fetal damage, including congenital malformations, when taken by pregnant women in their first trimester. Clonazepam is best avoided in the first trimester and probably throughout pregnancy.
• Benzodiazepines are secreted in breast milk. Mothers who are breastfeeding should not take clonazepam.