Pregabalin withdrawal in patients without psychiatric disorders taking a regular dose of pregabalin: A case series and literature review.

Pregabalin is a drug that can cause psychiatric symptoms via pregabalin withdrawal. Prior reports on pregabalin withdrawal have mainly focused on cases with pregabalin dependence or abuse, and little attention has been paid to patients who are prescribed regular doses of pregabalin. Herein, we report three cases of pregabalin withdrawal in patients without psychiatric disorders, taking regular doses of pregabalin, who developed psychiatric symptoms such as insomnia and anxiety after abrupt discontinuation of pregabalin. In addition, we conducted a systematic review of six case reports (previous studies) of pregabalin withdrawal under regular doses of pregabalin. Among the six cases, three patients had no comorbid mental or substance use disorders, the dose of pregabalin ranged from 150 to 600 mg/d, and the duration of pregabalin use ranged from a few weeks to many years. Of these six cases of pregabalin withdrawal, five had psychopathological symptoms, three had vegetative symptoms, and three had neurologic and physical complications. We concluded that since pregabalin withdrawal can occur even with regular doses and short-term use, clinicians must carefully reduce pregabalin doses when reducing or discontinuing treatment, paying close attention to withdrawal symptoms. Our case series sheds light on the scant evidence from previous research on physical dependence in patients who are taking regular doses of pregabalin. Furthermore, our cases were also valuable in demonstrating that pregabalin withdrawal can occur even after a relatively short period of 2 months.

Effects of acute alcohol ingestion on neuromotor functions.

To scrutinize the neuromotor effects of acute alcohol ingestion, postural sway, hand tremor, and reaction time were measured before and after alcohol or juice ingestion in 13 healthy volunteers at 20-22 years (mean 20.7) of age. The dose of ethanol consumed by the subjects (mean+/-S.D.) was 0.59+/-0.07 g/kg body weight, and the blood ethanol concentrations were estimated to be 0.86+/-0.23 g/l at 30 min after ethanol ingestion; 0.88+/-0.19 g/l at 70 min; 0.74+/-0.27 g/l at 130 min. The 1-h and 2-h changes in sway area, total transversal sway (Dx), and Dx at 0-1 Hz with eyes closed were significantly larger after alcohol ingestion than after juice ingestion. Similarly, the 2-h changes in sway area, total Dx, and Dx at 0-1 Hz with eyes open were significantly larger after alcohol ingestion than after juice ingestion. No significant differences were seen between alcohol and juice ingestion regarding changes in hand tremor or reaction time. These data suggest that the static balance due to acute alcohol ingestion is characterized mainly by transversal sway of low frequency (0-1 Hz) with eyes closed, which seems to differ from the characteristics of postural sway in alcoholics.