100 Migraine Drugs, A to Z: pregabalin

Pregabalin (Lyrica) is an epilepsy drug that is also approved by the FDA for the treatment of neuropathic (nerve) pain associated with diabetes, spinal cord injury, shingles (herpes zoster), and fibromyalgia. It is a controlled drug with a low risk of addiction and abuse, although it is often combined with other illicit drugs. Common side effects include dizziness, drowsiness, difficulty thinking clearly, weight gain, sexual dysfunction, and dry mouth. It also has many other less common side effects.

There are no large controlled trials of pregabalin for migraines only case series and anecdotal reports. However, because it does relieve pain and because two other epilepsy drugs, topiramate (Topamax, Trokendi, Qudexi) and divalproex sodium (Depakote) relieve migraines, at least theoretically it should be also effective for migraines. However, despite the few anecdotal reports, it does not appear to be very effective and often does cause side effects. I rarely prescribe it and have very few patients who benefit from it without side effects.