Pregabalin appears to be as effective as gabapentin for neuropathic pain; however costs more. It is effective for some people with postherpetic neuralgia and fibromyalgia. There is not enough data to state that it should be used in all neuropathic pain. It has not been found to be effective for HIV-associated peripheral neuropathy. Pregabalin binds to the α2δ (alpha-2-delta) subunit of the voltage-dependent calcium channel in the central nervous system. Pregabalin decreases the release of neurotransmitters including glutamate, norepinephrine, substance P and calcitonin gene-related peptide. However, unlike anxiolytic compounds (e.g., benzodiazepines) which exert their therapeutic effects through binding to GABAA, pregabalin neither binds directly to these receptors nor augments GABAA currents or affects GABA metabolism.
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