Pregabalin versus Gabapentin in Chronic Pain and CRPS Is one better than the other ? As far as I am aware, the answer is we don't really know. Some of the differences are :- 1. Gabapentin is more cost-effective (cheaper). Its license is epilepsy and neuropathic (nerve)pain 2. Pregabalin is slightly more expensive. It is licensed for epilepsy, neuropathic pain and generalised anxiety disorder. 3. Gabapentin can be taken up to 4 times a day. 4. Pregabalin should be taken twice a day. Although I usually take it 3 times a day. 5. Pregabalin has better GI absorption. 6. Pregabalin has more abuse potential. It is used by opioid (heroin , fentanyl, morphine, oxycodone and more) to prolong the action of the opioid 7. I have yet to find a chronic pain or CRPS patient who 'loves' effect of pregabalin. It is my clinical impression that you do not observe this in chronic pain and CRPS. 8. Both are addictive. This means that one has to reduce the dosage gradually. For example if you are taking pregabalin 900mg over a day and wish to reduce. Try going very slowly-reduce to 850mg first and wait one or two weeks. I think you will notice an effect, although beware of rebound pain. 9. Gabapentin and pregabalin have shown in studies to be highly effective in reducing one's perception of neuropathic pain. That is the pain is still there , yet we do not notice as much, many say they are so effective that they always know when next dose is due. 10. They are possibly the most effective medication and should be tried in combination with other. 11.They are difficult medicines to take and some simply cant tolerate them. Reference. 1. Chang C, McDonnell P, Eric Gershwin M. Complex regional pain syndrome – False hopes and miscommunications. Autoimmun Rev. 2019;(October 2018):1-9. doi:10.1016/j.autrev.2018.10.003 #pain #expert #pharmacist #doctor #CRPS #persistent-pain #chronic-pain