Is pregabalin (Lyrica) associated with weight gain?/nThe question concerns a 33-year-old woman, suc

Fråga: Is pregabalin (Lyrica) associated with weight gain? The question concerns a 33-year-old woman, successfully rehabilitated after a stroke four months ago. She was initially immobilized but has no remaining motoric sequelae. Because of neuropathic pain she started amitriptyline and one month after the stroke and yet another month later pregabalin was added. Since treatment was started she has gained about eight kilos.

Sammanfattning: Weight-gain is a common side-effect of pregabalin and may be dose-related. Peripheral oedema also is a common side-effect of pregabalin, therefore it is important to differentiate between these two causes of increased body-weight in patients treated with pregabalin.

Svar: Weight gain is associated with use of antidepressants and is probably due to successful treatment of depression with improved mental condition (1). For the tricyclic antidepressant amitriptyline weight-gain is listed as a common adverse effect (2).

Pregabalin has a GABA-like structure and is an antiepileptic used as an adjunct in the treatment of partial seizures with or without secondary generalisation. It is also used in the treatment of neuropathic pain. Weight gain is listed as a common side-effect of pregabalin (3).

One 12-week (n=191), double-blind, randomized study in patients with partial seizures reports weight gain in 7-14% of the patients depending on the dose (4). However, the above mentioned study does not report how large the weight gain was. Another 12-week study (n=238) where pregabalin was given for neuropathic pain, reports weight-gain defined as a seven percentage increase or more from baseline body-weight. In that study weight gain was reported in about 13 % of the patients receiving pregabalin (5). The cause of weight gain is unexplained but is according to the manufacturer not because of metabolic interference (6).

Another important side-effect reported as common for pregabalin is peripheral oedema. This is regarded a separate finding for pregabalin and not primary or secondary to alterations in cardiovascular function (7).

Both pregabalin and amitriptyline may be the cause of weight gain in the present case and we recommend that this case be reported to the regional adverse effect monitoring centre.