title: Spasticity increases during pregabalin withdrawal.
abstract: OBJECTIVE
  To determine whether pregabalin produces long-term spasticity reduction in subjects previously identified as responding in short-term trials.
  
  
  METHODS
  Prospective service evaluation of patients taking pregabalin for spasticity management for at least 1 year through a tertiary referral rehabilitation clinic. A graduated pregabalin withdrawal was undertaken as part of routine clinical management.
  
  
  METHODS
  Twelve of 19 potential subjects agreed to participate. The primary outcome measures were visual analogue pain and spasticity scores at lowest dose of pregabalin compared to baseline and their choice to resume pregabalin therapy.
  
  
  RESULTS
  Mean pre-withdrawal pregabalin dosage was 386 mg/day, decreasing to 70 mg/day at mean lowest dosage. Median subjective spasticity scores increased from 4 at baseline to 6 at lowest dose (p < 0.01) without a significant increase in median pain scores. Two patients with epilepsy, whose other anti-convulsants were not altered, had seizures. Following the evaluation, five subjects chose to return to the original dose, five recommenced pregabalin at a lower dose and two subjects no longer required the drug.
  
  
  CONCLUSIONS
  Pregabalin withdrawal resulted in self-reports of increased spasticity without a concomitant increase in pain, with 91% choosing to continue pregabalin at the conclusion of the evaluation.
authors.affiliation: Sacred Heart Rehabilitation Unit, St Vincent's Hospital, Sydney, Australia.
authors.forename: J J
authors.initials: JJ
authors.lastname: Braid
authors.forename: S G B
authors.initials: SG
authors.lastname: Kirker
authors.forename: I J
authors.initials: IJ
authors.lastname: Baguley
mesh_terms: D000700:Analgesics / Q000008:administration & dosage*; D000927:Anticonvulsants / Q000008:administration & dosage*; D001930:Brain Injuries / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D002547:Cerebral Palsy / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D010147:Pain Measurement; D000069583:Pregabalin; D011446:Prospective Studies; D013119:Spinal Cord Injuries / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D016896:Treatment Outcome; D028761:Withholding Treatment; D005680:gamma-Aminobutyric Acid / Q000008:administration & dosage / Q000031:analogs & derivatives*
chemical_list: D000700:Analgesics; D000927:Anticonvulsants; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid