Pregabalin is a neuronal calcium channel modulator that has been widely used in a number of clinical settings for its analgesic, anti-anxiety and anticonvulsant effects. In the United States and Europe, pregabalin has been approved for the treatment of neuropathic pain and partial seizures and is also used to treat fibromyalgia in the United States and is also approved for the treatment of generalized anxiety disorder in Europe.
To date, there has been a great deal of clinical trial data on pregabalin for different diseases. However, little is known about the effect of pregabalin on sleep. Recently, Professor Thomas Roth, from the Sleep Medicine Research Center at Henry Ford Hospital in the United States, summarized the literature on pregabalin sleep and systematically reviewed the effects of pregabalin on sleep patterns in the treatment of various diseases.
From a variety of patient self-rating scale results, pregabalin at the initial stage of medication that showed significant improvement in sleep, and efficacy to maintain the entire treatment phase. In most disease categories, it shows a dose-dependent improvement in sleep quality (except partial seizures), and in neuropathic pain and FM (especially FM) only at doses greater than 300 mg / d Will show this dose-dependent.
In polysomnography, pregabalin significantly reduced the time to wakeup (DPN, FM, RLS) and wakefulness (FM, partial seizures), prolonged slow wave sleep (FM, RLS, partial epilepsy Seizures), pregabalin also shorten the period of S1 sleep in patients with partial seizures of RLS and epilepsy. The above effect shows that pregabalin can mainly improve the depth of sleep and improve the quality of sleep. Pregabalin also shortened the duration of persistent sleep latency in patients with FM, but this effect is not much correlated with wakefulness, suggesting that pregabalin predominantly plays a role in sleep maintenance.
The classic clinical sedatives (benzodiazepine receptor agonists) mainly affect the S2 sleep, inhibit slow wave sleep or slow wave sleep does not work. Compared with classic sedatives, pregabalin unique is that it can extend the slow wave sleep time, and enhance the quality of sleep. In addition, classical sedatives play a major role in sleep-inducing rather than sleep sustaining, which is also different from pregabalin.
Previous studies often mistakenly believe that the effect of pregabalin on sleep improvement stems from its treatment of primary disease, whereas the results of this study suggest that pregabalin does not only act through its analgesic, anti-anxiety or anticonvulsant effects To indirectly affect the sleep condition, it can also have an impact on sleep directly. Therefore, it has been suggested at present that in the treatment of related diseases, attention should be paid not only to the disease itself, but also to the specific treatment of accompanying sleep disorders.
Pregabalin is known to have analgesic and anti-anxiety effects by inhibiting the release of neurotransmitters through its binding to a2-δ subunits of voltage-gated calcium channels in neurons. However, pregabalin The mechanism of sleep is not completely clear, may also be related to its regulation of calcium channels.