Pregabalin

Background

Pregabalin is a third line pharmacological option for the treatment of Generalised Anxiety Disorder.
The initiation of Pregabalin for generalised anxiety disorder by LSCFT clinicians is considered exceptional and as such a request form for the initiation of pregabalin for GAD needs to be completed by a specialist and submitted for approval within the Trust by the Chief Pharmacist and Deputy Medical Director. LSCFT clinicians initiating the drug must confirm the following:
• I have fully considered the risks and benefits of prescribing this medication for this patient
• I have discussed the likely efficacy of the drugs for management of their symptoms and also about the risk of harms, including dependence
• If the request is approved and the patient has no improvement in symptoms, the drug will be reduced and stopped.
• If the request is approved and treatment is successful, I will consider a reduction on a regular basis to ascertain ongoing effectiveness in line with recommendations in the NHS England document.
• If dependence on pregabalin or gabapentin, or other misuse or diversion, is suspected or identified the patient will be reviewed and concerns discussed sensitively and documented clearly
• If dependence on prescribed medication is suspected or confirmed, the care plan will be revisited. If it appears that the medication is no longer required for the main clinical indication the patient will be reassessed and planned withdrawal of the medication considered.
• If completely inappropriate use is confirmed (e.g., if there is unequivocal objective evidence that the drugs are simply being diverted) the medication will be stopped. If partial diversion is suspected or confirmed the patient will be reassessed and a planned withdrawal of medication considered.