Lyrica (pregabalin) vs. Xanax (alprazolam)

• Lyrica (pregabalin) and Xanax (alprazolam) are used to treat seizures and anxiety disorder.
• Lyrica is also used to treat neuropathic pain associated with diabetic peripheral neuropathy or postherpetic neuralgia, and fibromyalgia. Lyrica is also used in combination with other drugs to treat partial onset seizures in adults.
• Xanax is primarily used to treat anxiety disorders and panic attacks.
• Lyrica and Xanax belong to different drug classes. Lyrica is an anti-epileptic drug (AED) and Xanax is a benzodiazepine.
• Side effects of Lyrica and Xanax that are similar include fatigue, drowsiness, memory problems, constipation, weight changes, and dry mouth.
• Side effects of Lyrica that are different from Xanax include dizziness, nausea, fluid retention (edema), blurred vision, double vision, abnormal gait, tremor, difficulty concentrating, increased appetite, gas, 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.
• Side effects of Xanax that are different from Lyrica include speech problems, addiction (dependency), and headache.
• Withdrawal symptoms may occur if you suddenly stop taking Xanax.

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.

Xanax (alprazolam) is an anti-anxiety medication used to treat anxiety disorders and panic attacks. Xanax is a benzodiazepine, the same drug class as diazepam (Valium), clonazepam (Klonopin), lorazepam (Ativan), flurazepam, and (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 activity in the brain. It is believed that excessive activity in the brain may cause anxiety or other psychiatric disorders.

Lyrica

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).

Xanax

The most common side effects of Xanax taken at lower doses are:

• Drowsiness
• Fatigue

Other side effects include:

• Memory problems
• Speech problems
• Constipation
• Changes in weight
• Addiction (dependency)
• Headache
• Constipation
• Dry mouth

Lyrica

Addiction is not listed as a side effect for Lyrica

Xanax

Withdrawal and addiction are more likely to occur at high doses given over prolonged periods. Abrupt discontinuation of alprazolam after prolonged use can lead to symptoms of withdrawal such as:

• Insomnia
• Headaches
• Nausea
• Vomiting
• Lightheadedness
• Sweating
• Anxiety
• Fatigue

Seizures can occur in more severe cases of withdrawal. Consequently, patients on alprazolam for extended periods of time should slowly taper the medication under a doctor's supervision rather than abruptly stopping the medication.

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.

Xanax

• The starting dose for treating anxiety is 0.25-0.5 mg 3 to 4 times daily using immediate release tablets. The dose may be increased every 3-4 days to a maximum dose of 4 mg daily.
• The starting dose for treating panic attacks is 0.5 mg 3 times daily. Doses can be increased every 3-4 days but by no more than 1 mg daily.
• The effective dose for preventing panic attacks may be as high as 10 mg daily for some patients. The starting dose when using extended release tablets to treat panic disorder is 0.5 mg once daily and the average dose is 3-6 mg once daily.
• Alprazolam may be taken with or without food.

Lyrica

• Alcohol and 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.

Xanax

• Ketoconazole (Nizoral), itraconazole (Sporanox), nefazodone (Serzone), cimetidine (Tagamet), and fluvoxamine (Luvox) increase concentrations in the blood of alprazolam and therefore may increase the side effects of alprazolam.
• Alprazolam interacts with alcohol and medications (for example, barbiturates, and narcotics) that suppress activity in the brain by suppressing activity more and causing sedation.
• Carbamazepine and rifampin reduce the effect of alprazolam by increasing metabolism and elimination of alprazolam in the liver.

Lyrica

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

Xanax

• Benzodiazepines, such as alprazolam, can cause fetal abnormalities and should not be used in pregnancy.
• Alprazolam is excreted in breast milk and it can affect nursing infants. Therefore, women who are should not take alprazolam while breastfeeding.