Mechanism of action
- Analog of neurotransmitter GABA
- Binds the alpha-2delta unit of calcium channels reducing calcium influx
- Causes reduced release of glutamate, noradrenaline and substance P
Indications
- Diabetic neuropathy
Dosing
Common side effects
- Somnolence
- Dizziness
- Weight gain
- Peripheral oedema
- Ataxia
- Dry mouth
Rare side effects - be aware!
- Rhabdomyolysis
- Acute renal failure
- Hyperthermia
- Secondary acute angle glaucoma
Liver and kidney issues?
- Titrate dose in renal failure
- No changes required in liver failure
Golden pearls
- Does NOT bind GABA receptors and is NOT converted into GABA (Trap!)
- Can improve mood and sleep
- Affects balance so use carefully in elderly/falls risks
- They are considered more benign than the TCAs due to side effect profile
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