pregabalin and Body-Weight

We examined patterns of weight change among patients treated with pregabalin for up to 1 year.. Patients with ≥1 pre-treatment weight measurement, ≥2 measurements in Period 1 (day 2-56), and ≥2 during Period 2 (day 57-356) were identified from pooled data of 106 studies including 43,525 patients. Seven patterns were developed and used for exploratory 'change point' analyses (day on-treatment when weight-change trend changed from initial trajectory) and to assess patterns of weight change by baseline weight/body mass index (BMI).. A total of 3187 patients (from 41 studies) were eligible. 98.9% of patients were described by three of the seven patterns. The majority of patients (2607/3187 [81.8%]) remained within ±7% of baseline weight ('Pattern 4'). Fewer patients (463/3187 [14.5%]) were 'delayed weight gainers' (exceeded 7% weight gain in Period 2 but not Period 1 ['Pattern 6']), fewer still (82/3187 [2.6%]) were 'early weight gainers' (exceeded ≥7% baseline weight in Period 1 and remained above 7% or continued to gain weight in Period 2 ['Pattern 7']). Overall weight gainers (Patterns 6, 7) experienced 1-year weight gain (median [% change]) of +6.20 kg [+9.12%] and 5.46 kg [+13.9%] vs. 2.22 kg [+2.10%] for non-weight gainers (Pattern 4). Average baseline weight/BMI was lower for weight gainers (Patterns 6, 7) versus other patterns. Early weight gainers (Pattern 7) had change point day at day 40 versus day 54 for Pattern 4 and day 69 for Pattern 6. Use of concomitant medications and influence of comorbid conditions on weight should be considered as inherent variables when interpreting the study.. The majority of patients treated with pregabalin (150-600 mg/day) for 1 year maintained weight within ±7% baseline weight. One in six patients gained ≥7% weight from baseline, and generally exceeded 7%, 2-12 months after treatment onset.

Topics: Adult; Aged; Anticonvulsants; Body Weight; Comprehension; Diabetic Neuropathies; Epilepsies, Partial; Female; Fibromyalgia; gamma-Aminobutyric Acid; Humans; Male; Middle Aged; Neuralgia, Postherpetic; Pregabalin; Weight Gain

Pregabalin (PGB) drug abuse is common among the youth. It substituted tramadol before its recent schedule as a controlled drug since April 2019. PGB is an antiepileptic drug acting on the central nervous system. It blocks calcium channels regulating the action of neurotransmitters and causing prolonged depolarization. The present study aimed to investigate the toxic effect of long term pregabalin abuse on the reproductive function and body weight in both male and female albino rats and to evaluate the ameliorative effect of wheat germ oil (WGO). Forty-eight rats were randomly divided into eight groups. The first four groups were males and they were treated as follows: control group (1.5 mL saline), WGO group (1.5 mL L/kg), PGB group (300 mg/kg), and protective group (PGB + WGO). All doses were administrated once per day for 60 days by gastric gavage. The second four groups were females. They were divided and treated the same as the male groups. Pregabalin caused significant weight loss, decreased serum triglyceride level, and increased leptin gene expression in all rats. PGB affected male rats reproduction by decreasing total testosterone serum level and inhibiting spermatogenesis. Reproductive toxicity in females was caused by decreasing pituitary steroids, increasing gonadal hormones, and increasing the number of atretic ovarian follicles. Mechanism of toxicity may be attributed to the PGB oxidative stress effect that induced apoptosis and caused diffuse gonadal atrophy. WGO showed a protective effect on PGB induced toxicity as all measured parameters were relatively improved.

Topics: Animals; Body Weight; Caspase 3; Female; Leptin; Oxidative Stress; Plant Oils; Pregabalin; Protective Agents; Rats; Reproduction

Pregabalin is useful for treating neuropathic pain, but known to increase body weight as a side effect. To investigate the mechanism of this increase in body weight, we focused on dopamine in the lateral hypothalamus (LH) and examined the effects of pregabalin on dopamine levels in the LH and food intake. The dopamine levels in the LH was gradually decreased during fasting. When the animals were fed, dopamine levels in the LH was significantly increased, indicating that dopamine levels in the LH reflects energy state. The systemic injection of pregabalin tended to decrease dopamine levels in the LH after feeding. The dopamine levels in the LH was also significantly increased by glucose injection, which was inhibited by pregabalin. These results suggest that pregabalin inhibits dopaminergic function in the LH, which might increase food intake. To make these points clear, we examined the effects of pregabalin on food intake and blood glucose levels. Pregabalin significantly increased food intake, whereas pregabalin did not affect blood glucose levels. These results indicate that pregabalin stimulates feeding behavior, but not glucose metabolism. Moreover, the non-selective dopamine receptor antagonist cis-(Z)-flupenthixol injected into the LH significantly increased food intake, though neither the dopamine D

Topics: Animals; Benzazepines; Blood Glucose; Body Weight; Dopamine; Dopamine Antagonists; Dopaminergic Neurons; Eating; Feeding Behavior; Hypothalamic Area, Lateral; Hypothalamus; Male; Mice; Mice, Inbred ICR; Microdialysis; Nucleus Accumbens; Pregabalin; Rats; Rats, Wistar; Receptors, Dopamine D1; Receptors, Dopamine D2

As one of trials on neuroprotection after spinal cord injury, we used pregabalin. After spinal cord injury (SCI) in rats using contusion model, we observed the effect of pregabalin compared to that of the control and the methylprednisolone treated rats. We observed locomotor improvement of paralyzed hindlimb and body weight changes for clinical evaluation and caspase-3, bcl-2, and p38 MAPK expressions using western blotting. On histopathological analysis, we also evaluated reactive proliferation of glial cells. We were able to observe pregabalin's effectiveness as a neuroprotector after SCI in terms of the clinical indicators and the laboratory findings. The caspase-3 and phosphorylated p38 MAPK expressions of the pregabalin group were lower than those of the control group (statistically significant with caspase-3). Bcl-2 showed no significant difference between the control group and the treated groups. On the histopathological analysis, pregabalin treatment demonstrated less proliferation of the microglia and astrocytes. With this animal study, we were able to demonstrate reproducible results of pregabalin's neuroprotection effect. Diminished production of caspase-3 and phosphorylated p38 MAPK and as well as decreased proliferation of astrocytes were seen with the administration of pregabalin. This influence on spinal cord injury might be a possible approach for achieving neuroprotection following central nervous system trauma including spinal cord injury.

Topics: Animals; Apoptosis; Astrocytes; Blotting, Western; Body Weight; Caspase 3; Cell Proliferation; Fluorescent Antibody Technique; gamma-Aminobutyric Acid; Gene Expression; Hindlimb; Inflammation; Male; Methylprednisolone; Microglia; Motor Activity; Neuroglia; Neuroprotective Agents; p38 Mitogen-Activated Protein Kinases; Paralysis; Pregabalin; Proto-Oncogene Proteins c-bcl-2; Rats; Rats, Sprague-Dawley; Spinal Cord Injuries

Pregabalin (PGB) was licensed in Europe as an add-on antiepileptic drug (AED) for the treatment of partial-onset seizures in 2004. This audit assessed the response to adjunctive PGB in patients with uncontrolled seizures.. PGB was titrated in 135 patients [73 men; 62 women, aged 18-76 (median 44 years) until one of the following occurred: ≥ 6 months' seizure freedom, ≥ 50% or < 50% seizure reduction over 6 months; PGB withdrawal because of adverse effects, lack of efficacy or both.. Of the 135 patients, 14 (10.4%) became seizure-free for ≥ 6 months (median PGB dose 300 mg/day; range 75-600 mg). A ≥ 50% seizure reduction occurred in 33 (24.4%) patients; 20 (14.8%) had < 50% reduction. PGB was withdrawn in 68 (50.4%) (40 adverse effects, seven lack of efficacy and 21 both). Commonest problems resulting in withdrawal were sedation (n = 18), weight gain (n = 14) and ataxia (n = 9). There was a positive correlation between increasing dose and weight gain (r = 0.42, P = 0.045).. Add-on PGB benefited 50% of patients, but only 10% achieved 6 months' seizure freedom. Adverse effects, most commonly sedation, dose-related weight gain and ataxia, led to drug discontinuation by 45%. Prospective audits of novel AEDs are a useful adjunct to randomized, controlled trials in managing epilepsy.

Topics: Adolescent; Adult; Aged; Anticonvulsants; Body Weight; Dose-Response Relationship, Drug; Drug Administration Schedule; Drug Therapy, Combination; Female; gamma-Aminobutyric Acid; Humans; Male; Middle Aged; Pregabalin; Prospective Studies; Seizures; Substance Withdrawal Syndrome; Treatment Outcome; Young Adult

Topics: Adverse Drug Reaction Reporting Systems; Analgesics; Anti-Anxiety Agents; Body Weight; Conflict of Interest; Controlled Clinical Trials as Topic; GABA Agonists; gamma-Aminobutyric Acid; Humans; Pain; Placebo Effect; Pregabalin; Reproducibility of Results; Research Design; Spinal Cord Injuries; Substance Withdrawal Syndrome; Synaptic Transmission; Treatment Outcome

To characterize change from baseline weight over time for pregabalin and placebo administration.. Asymptotic fraction of baseline weight was modeled with a nonmixture model and a mixture model as a function of baseline weight, exposure, time, covariate effects, and subject-specific random effects. Model fit was assessed using standard diagnostic plots. Predictive performance was assessed using both data similar to the original data, and open-label data.. The nonmixture model indicated that a typical patient (baseline weight 82 kg) receiving placebo or 300 mg/day pregabalin approached an asymptotic fractional change from baseline weight of [mean (95% prediction interval for typical individual)] 0.7% (-5.5% to 7.4%) or 2.5% (-3.8% to 9.1%), respectively, with a half-life of 17 days. Substantial between-subject variability is observed, with some drug-treated subjects remaining weight neutral or losing weight, at all levels of exposure. Structural fixed effects parameters for the two submodels (mixture model) were in close agreement with each other and with those for the nonmixture model. The mixture model described two subpopulations differing in interindividual variability. No significant interindividual-varying covariates influencing the mixture probabilities were identified other than exposure. Both models had adequate fit; both models performed well during external validation. Predictive performance (nonmixture model) was adequate to ~900 days.. The weight of a typical 82-kg patient receiving placebo or pregabalin (300 mg/day) approaches an asymptotic fractional change from baseline weight of 0.7%, or 2.5%, respectively, with a half-life of 17 days. Substantial between-subject variability remains unexplained.

Topics: Body Weight; Clinical Trials as Topic; Female; gamma-Aminobutyric Acid; Humans; Male; Models, Biological; Placebos; Pregabalin