Treatment Database

An alpha-2-delta calcium channel ligand structurally related to pregabalin, used for fibromyalgia pain, neuropathic pain, and sleep disturbance. In chronic neuropathic pain (mainly diabetic neuropathy and post-shingles pain), a Cochrane review found about 35% achieved substantial pain relief vs 21% on placebo. Fibromyalgia evidence is thinner: a separate 2017 Cochrane review found one 12-week trial (n=150; 49% vs 31% with at least 30% less pain) and rated the evidence very low certainty. Small fiber neuropathy has only case reports. Pregabalin generally shows superior and faster efficacy in head-to-head neuropathic pain comparisons, but gabapentin is cheaper and widely accessible. Also used off-label for restless legs, anxiety, and sleep.