How can I replace Pregabalin without a prescription?

Pregabalin is an effective drug in demand in psychiatry, neurology, and rheumatology, which is available only by prescription. The drug and its over-the-counter analogues quickly cope with epileptic seizures, anxiety, and musculoskeletal pain.

Characteristics of the drug

Pregabalin is a pharmacological drug that was previously freely sold in pharmacies. It was in demand among patients with epilepsy, acute pain in muscles and joints, and increased causeless anxiety. About 5 years ago, Pregabalin was sold upon presentation of a prescription from a doctor. And all because of the pronounced side effects - euphoria, lethargy, confusion. When combined with alcohol, auditory and visual hallucinations are common.

Symptoms of withdrawal syndrome from drugs containing pregabalin

Abstinence develops if you stop taking it abruptly. The brain does not receive enough stimulant and requires a new dose. Withdrawal syndrome is accompanied by:

• persistent insomnia;
• abdominal pain;
• anxiety, irritability, mood swings;
• thirst, dyspeptic disorders;
• hypertension;
• heart rhythm disturbance.

The peculiarity of addiction is that in the post-abstinence period, episodes of exacerbation of cravings occur, depression develops, and after discontinuation of the anticonvulsant, breakdowns and relapses of the disease are observed.

Release from pharmacies

Just a few years ago, dispensing structural analogues of Pregabalin was a headache for pharmacy employees. Pharmacists and pharmacists have encountered inappropriate behavior from clients with persistent drug addiction. Despite the fact that they were buying an expensive (about 1,000 rubles) drug on an industrial scale, sales were falling. It’s just that respectable citizens preferred not to visit pharmacies where drug addicts constantly shopped.

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Not surprisingly, structural substitutes soon disappeared from the shelves. At first, pharmacies themselves stopped purchasing it in order to preserve their reputation. And then the Ministry of Health banned its sale without a prescription.

The reason is the sale of the drug to minors at parties and even in schools.

Now Pregabalin is a drug prohibited from free sale. But many pharmacies are still subject to huge fines for violating this law.

Literature:

1. Delinquency of “Pharmacy drug addiction” as a determining factor in strengthening control over the circulation of medicines / Vladimir Ilyich Zhukovsky, Natalya Vladimirovna Dovgolyuk / 2021 / Humanitarian and legal research
2. A short reference book on psychopharmacology, pharmacotherapy and mental pathology / Kozlovsky, Vladimir Leonidovich. - St. Petersburg: SpetsLit, 2015.
3. Current classifications of medicines: textbook / compilers: Galustyan A. N. et al. - St. Petersburg: SPbGPMU, 2018. - 54 p.

What are over-the-counter analogs intended for?

The main indication for the use of Pregabalin analogs is the relief of acute pain in the musculoskeletal system. They are used both as monotherapy and as part of complex treatment with narcotic and non-narcotic analgesics, non-steroidal anti-inflammatory drugs. The drugs help patients with the following pathological conditions:

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• neuropathic pain, which is not a response to physical damage, but is associated with disturbances in the functioning of areas of the peripheral and central nervous systems;

• generalized anxiety disorders, which are manifested by increased nervous excitability, sleep disorders, depression;
• Fibromyalgia is a chronic pain syndrome characterized by musculoskeletal pain and the presence of specific points of increased sensitivity.

Substitutes are intended to eliminate partial epileptic seizures. They are most often used in combination with other anticonvulsants. The use of drugs is also recommended for the prevention of another attack of epilepsy.

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conclusions

Lyrica is effective in the treatment of anxiety disorders and epilepsy. However, it is quite dangerous, addictive, and has a wide range of side effects. If possible, if the patient’s condition allows, it is advisable to use milder drugs like Lyrica for their therapeutic effect.

Analogue drugs Lyrica containing aminophenylbutyric acid, such as Phenibut, Noofen, Anvifen, are also effective in anti-anxiety therapy and are used as a complex therapy for the treatment of seizures. And at the same time, they have virtually no side effects. They can be purchased as sports nutrition without prescriptions.

Structural analogues of Pregabalin

In pharmacies, the free sale of not only Pregabalin, but also all its structural analogues is prohibited. This is the name for pharmacological drugs with identical active ingredients. Exact analogues of the drug:

• Lyrics
  . A drug from German with a pronounced antiepileptic effect. It is characterized by accelerated absorption of the active ingredient due to the characteristics of the auxiliary composition;

• Algerica
  . Produced by the Croatian pharmaceutical factory PLIVA HRVATSKA in the form of capsules of various colors. The cost of Algerica is approximately the same as that of Pregabalin - 1000 rubles.

Relatively recently, the domestic pharmaceutical factory North Star began producing Pregabalin. The capsules contain pregabalin, but the auxiliary composition differs somewhat from the Hungarian drug. But this does not affect the therapeutic effectiveness of the drug. A doctor can prescribe Pregabalin to a patient, both imported and domestically produced.

Current substitutes

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For the treatment of fibromyalgia, epilepsy, and anxiety disorders, there are many drugs similar in action to Pregabalin. They differ in active and additional ingredients, release form, and you can buy them without a prescription.

All drugs are substitutes for Pregabalin, but rarely become the first choice in the treatment of epilepsy and neuropathic pain. They are safer and less likely to cause adverse reactions. But Pregabalin relieves the symptoms of pathologies better and faster and provides long-term remission.

Over-the-counter analogues with antiepileptic action

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Pregabalin analogues with powerful anticonvulsant activity are used in the treatment of epilepsy. But all of them are available only by prescription, as they are addictive. Pharmacies sell medicines that have a mild sedative and calming effect. They do not stop epileptic seizures, but prevent their occurrence. Over-the-counter substitutes for Pregabalin include the following pharmacological drugs:

• Novo-Passit;
• Noopept;
• Tenoten.

The list of natural over-the-counter analogues of Pregabalin includes herbal products with a sedative effect. Motherwort, valerian, and peony are good for calming. They are used as part of complex therapy for partial epilepsy. These drugs are also indicated for the elimination of anxiety disorders, like Pregabalin.

Herbal over-the-counter substitutes for Pregabalin normalize sleep and prevent the development of depressive conditions.

They cope with constant nervousness, trembling, muscle tension, sweating, palpitations, dizziness and discomfort in the solar plexus area.

Analogs

Drugs containing pregabalin appeared on the pharmaceutical market relatively recently - in 2010. And since 2015, they began to be sold only by prescription, although they remain legal medicines. The drug was developed by Pfizer. Trade name: Lyrica. Currently, its analogues are produced by many pharmaceutical companies.

Which drugs contain pregabalin:

• Algerica - Teva Ukraine;
• Gabana - Kievmedpreparat, Ukraine;
• Galara - World Medical Ilac, Türkiye;
• Zonik - Kusum Healthker, India;
• Ligato - Medokemi, Cyprus;
• Linbag - FC Lek, Slovenia;
• Maxgalin - India;
• Neogabin - Ukraine;
• Ogrania - Ukraine;
• Pagamax - Türkiye;
• Pregabalin-Darnitsa - Ukraine;
• Pregabalin-Richter - Russia;
• Cramp - India;
• Torgabalin - India;
• Exista - Poland.

Dosage form: capsules for oral administration. Available in dosages of 50, 75, 150 and 300 mg of the active substance.

Non-prescription painkillers

The closest analogues of Pregabalin are narcotic analgesics, the free sale of which in pharmacies is strictly prohibited. Non-steroidal anti-inflammatory drugs can relieve acute pain. These over-the-counter substitutes are available as parenteral products, tablets, and ointments. But in terms of the power of analgesic action, only injection solutions with the following active ingredients are similar to Pregabalin:

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• nimesulide;
• diclofenac;
• ketoprofen.

Over-the-counter substitutes for Pregabalin inhibit cyclooxygenase, an enzyme responsible for the synthesis of prostaglandins, bradykinins, and leukotrienes. They are the cause of all the discomfort with fibromyalgia. Nonsteroidal anti-inflammatory drugs eliminate not only muscle-bone pain, but also other characteristic symptoms of severe pathology. These are acute migraine-type headaches and restless legs syndrome.

Restrictions on treatment

An absolute contraindication to treatment with over-the-counter analogs of Pregabalin is individual intolerance to the active or excipient. Neurologists, psychiatrists, and psychotherapists do not prescribe them to patients when diagnosing them with the following pathologies:

• lack of lactase enzyme in the body;
• milk sugar intolerance;
• glucose-galactose malabsorption.

Some over-the-counter substitutes are not used if you have severe liver or kidney disease. The list of relative contraindications includes severe pathologies of the liver and kidneys, heart failure. Taking medications in childhood and adolescence is strictly prohibited. This is also true for patients who are pregnant or breastfeeding.

A doctor will never prescribe structural analogues of Pregabalin to a person if his medical history contains evidence of previously identified drug dependence.

Drugs provoke addiction quite quickly. People get used to euphoria, lethargy, and drowsiness, so it is difficult for them to refuse the drug.

Consequences of pregabalin addiction

Regular use of anticonvulsants without indications or exceeding recommended dosages causes disruption of all body systems. A person develops:

• arrhythmias, hypertension;
• pulmonary edema;
• pancreatitis, problems with bowel movements;
• myalgia;
• urinary incontinence;
• decreased immunity;
• impotence in men, amenorrhea in women;
• impairment of intellectual abilities;
• depression;
• development of schizophrenia;
• aggressiveness.

An overdose results in coma and death from kidney and heart failure.

Current prescription analogues

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Drugs from various clinical and pharmacological groups have similar therapeutic properties. When choosing a Pregabalin substitute, the doctor is guided by the prevalence of certain symptoms in the clinic. To treat fibromyalgia, you need one that can quickly eliminate acute pain. With high-quality analogues, the analgesic effect lasts for a day or more.

Other high-quality analogues, like Pregabalin, immediately stop an epileptic seizure. But their mechanism of action on the central nervous system is somewhat different. They block the transmission of impulses or have a direct effect on certain parts of the brain.

Gabapentin capsules

It is an anticonvulsant that is used to treat epilepsy as well as neuropathic pain. Gabapentin is similar in structure to aminobutyric acid, but it is not capable of blocking GABA receptors directly. An anticonvulsant is prescribed by doctors to patients with the following pathologies:

• focal seizures;
• resistant epilepsy;
• migraine;
• postherpetic neuralgia, alcoholic.

Gabapentin is sometimes used during natural menopause to relieve congestion in the face and upper body. Unlike Gabapentin, it does not provoke addiction or withdrawal symptoms and is used in pediatrics.

Finlepsin and Carbamazepine

Finlepsin and its domestic analog Carbamazepine are antiepileptic drugs. They exhibit pronounced analgesic, normothymic, antimanic and antidiuretic activity. The drugs reduce the release of glutamate, which has an stimulating effect. Therefore, they are in demand in the treatment of diseases complicated by anxiety, depression, irritability and aggressiveness:

• idiopathic neuralgia of the glossopharyngeal or trigeminal nerve;
• acute manic states;
• phasic affective disorders;
• alcohol withdrawal syndrome.

Finlepsin and Carbamazepine do not have a wide list of contraindications. But due to their toxicity to the liver, treatment is carried out with constant monitoring of its functional indicators.

Depakin Chrono

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Depakine Chrono is an anticonvulsant drug that has a central muscle relaxant and sedative effect. The active ingredient is valproic acid, which has a normothimic effect. Depakine Chrono is included in therapeutic regimens after diagnosing the following pathologies in adults and children:

• generalized epileptic seizures;
• Lennox-Gastaut syndrome;
• partial epileptic seizure.

Depakine Chrono has a distinct advantage - its inability to cause physical and psychological addiction. Compliance with the recommendations of a neurologist, psychotherapist, orthopedist, and rheumatologist is required. But you need to take into account the lack of compatibility with alcohol and antipsychotics.

Pregabalin

Pregabalin is a synthetic antiepileptic drug. Indicated for neuropathy, trigeminal neuralgia, and increased anxiety. Effective in the treatment of chronic pain. A decrease in the frequency of seizures is observed already in the first week of use.

Preparations containing pregabalin are used in the treatment of opioid addiction. They are used to relieve neurogenic pain that accompanies withdrawal symptoms. Medical statistics describe cases of abuse of pregabalin drugs. It is chemically similar to endorphins. During the reception, joy and a feeling of lightness arise. A common side effect of antiepileptic drugs is euphoria. It appears in people who abuse alcohol or take drugs. The drug is dose-dependent and occurs in 5.1% of patients taking more than 300 mg/day.

In controlled clinical trials, it was proven that abuse developed in 4% of cases. 5.5 thousand volunteers participated in the research. The first cases of addiction to pregabalin were identified in 2008 in Scandinavian countries. To form it, according to narcologists, 1-2 doses of an anticonvulsant are sufficient.

In addition to exceeding recommended dosages, non-traditional routes of administration are used to achieve euphoria. Pregabalin is available in tablet form. Addicts use it inhalation, rectally, by injection, and combine it with other drugs. Use simultaneously with opiates causes severe intoxication.

How to take medications correctly?

According to the instructions, over-the-counter Pregabalin substitutes should be used in accordance with the dosage regimen determined by the doctor. He calculates the required amount of drugs taking into account the type of pathology diagnosed, the severity and form of its course. The doctor must take into account the patient’s age and general state of health. For neuropathic pain and epilepsy, medications are used 1-3 capsules up to three times a day.

Capsules or tablets are swallowed whole with plenty of water. They should not be chewed, as most of the pregabalin will be destroyed by aggressive gastric juice. It is not recommended to take capsules on an empty stomach due to an excessive increase in the therapeutic concentration of the main component in the systemic circulation. If a dose is missed, both prescription and over-the-counter Pregabalin substitutes are taken as quickly as possible.

Possible side effects

Side effects can be avoided by carefully following medical recommendations. It should be borne in mind that frequent use of over-the-counter analogues can cause an overdose. Most often, adverse systemic reactions from the body are manifested by the following symptoms:

• constriction of the pupils;
• muscle weakness;
• dizziness, confusion, impaired coordination of movements;
• feeling of lack of air when inhaling, shortness of breath;
• decrease in general body temperature;
• pale skin, cyanosis of the nasolabial triangle;

• diarrhea or constipation;
• suppression of appetite, flatulence, attacks of nausea and vomiting;
• decreased heart rate;
• headaches;
• visual and hearing disorders;
• dry mouth.

Taking capsules or tablets leads to the development of local adverse reactions. They manifest themselves as typical signs of urticaria - swelling of the skin, redness, rash, itching, pain when touched. If any side effect is detected, you should consult a doctor. He will reduce the dose or replace the drugs with other, safe analogues.

Action Lyrics

The exact mechanism of action of Lyrica on the human body is not fully understood. High doses of the drug cause a person to experience feelings similar to the euphoria after taking opioids (heroin or morphine).

Among drug addicts, the combination of a small amount of alcohol and Lyrica capsules is very popular. The effects of this analgesic and ethanol are mutually enhanced. Consumption of this kind of “cocktail” quickly leads to mental disorders and the development of somatic disorders.

Possible side effects of Lyrica:

• vestibular disorders (unsteadiness of gait or inability to maintain an upright position);
• weakening of reflexes (general inhibition);
• speech disorders (slurred pronunciation of words);
• defects (loss) of visual fields;
• change or complete loss of taste;
• dizziness;
• deterioration in the ability to concentrate;
• mental and motor excitement;
• cardiopalmus;
• tremor (trembling of limbs);
• sweating;
• insomnia.

In severe cases, clonic convulsions, stupor, and even coma may develop.

Sleep disturbances quite quickly lead to exhaustion of the nervous system, which in turn contributes to mental instability. Consumption of doses significantly higher than therapeutic doses causes mood swings; peace may give way to depression or anxiety. One of the symptoms of taking Lyrica is panic attacks. In a state of drug intoxication, the patient may show aggression towards others.

It is quite difficult to recognize a person who has been using Pregabalin for a short time. As long-term addiction develops, the signs become more noticeable. After each next dose, the pupils dilate, and the gaze becomes glazed and frantic.

Evaluating the performance of analogues

Despite the list of side effects of analogues, they are rarely observed in clinical practice. Pregabalin and substitutes are well tolerated and quickly improve the well-being of patients. They eliminate the most severe pain and reliably prevent epileptic seizures. The drugs are combined with all drugs with analgesic and anticonvulsant activity.

Pregabalin substitutes also include injection solutions of glucocorticosteroids - Triamcinolone, Hydrocortisone, Prednisolone. They are usually injected into the joint cavity for fibromyalgia. The pain disappears instantly, inflammatory processes stop, swelling subsides. But glucocorticosteroids have no less contraindications than Pregabalin.