A systematic review of pregabalin: Therapeutic benefits, psychological risks, and case reports analysis

Pregabalin, a gamma-aminobutyric acid analogue, is extensively used for neurological and psychiatric disorders, such as neuropathic pain, anxiety, and epilepsy. Although its clinical efficacy is not in doubt, increasing evidence indicates a high risk of psychological side effects and abuse, and concerns regarding safety and dependency. Our systematic review found severe psychiatric symptoms such as psychosis, hallucinations, anxiety, and depression with pregabalin. These effects were intensified by factors such as high doses, sudden withdrawal, and preexisting psychiatric illness. Sexual disinhibition and dependency cases were reported, especially in substance-dependent patients. Effective management involved tapering doses gradually, adjunct psychiatric treatment, and close monitoring.