Is Lyrica (pregabalin) addictive?

The more serious danger is the mix: with opioids, sleeping tablets or other sedative medicines, the same label reports respiratory failure, coma and deaths.

Many people who become dependent on pregabalin started with a doctor’s script for nerve pain or anxiety. At Renewed Life Center in Lakeside, Cape Town, we treat the dependence together with the anxiety, low mood or poor sleep under it.

Is Lyrica addictive? Pregabalin addiction and prescription drug abuse

Pregabalin addiction starts with tolerance: the nervous system adapts to being calmed every day, needs more for the same effect, and protests when a dose is missed. Lyrica’s South African label tells prescribers to watch for “development of tolerance, dose escalation and drug-seeking behaviour”. The same adjustment sits behind most prescription drug abuse.

The label names two groups as possibly “at higher risk”: people with a history of substance abuse and people with psychiatric disorders. A review of 106 studies (Bonnet and Scherbaum, 2017) rated pregabalin somewhat more addictive than its older relative, gabapentin.

A capsule that settles nerve pain also takes the edge off the late-night thinking, a marriage under strain, a grief nobody talks about. If the capsules go and the reason stays, the reason finds something else. NIDA advises treating co-occurring conditions at the same time, and we work that way. Ruby Weber, the psychologist who heads psychology at the centre and has more than 20 years in the addictions field, leads the work on anxiety, depression and trauma while the medical side of coming off runs alongside it.

Why pregabalin addiction is easy to miss

Pregabalin addiction is easy to miss because it arrives in a pharmacy bag with a doctor’s name on the label. Families usually notice the mood before the medicine: calm and chatty one evening, flat and short-tempered the next morning, the repeat script collected a few days earlier each month.

The numbers miss it too. SACENDU, South Africa’s treatment monitoring network, groups over-the-counter and prescription medicines together: between 1% and 3% of people in treatment by region reported using them in the second half of 2025.

Commonly misused prescription medications in South Africa

The prescription medicines most often misused in South Africa fall into five groups: gabapentinoids such as Lyrica, codeine painkillers, benzodiazepines, sleeping tablets and ADHD stimulants. They are often part of a mix: in the Western Cape, 63% of people in treatment reported using more than one substance in the second half of 2025, SACENDU found.

Pregabalin (Lyrica) and gabapentin: what it is and why it is prescribed

In South Africa Lyrica is a Schedule 5 medicine, and its insert lists nerve pain from shingles and diabetes among its uses. The usual starting dose is 75mg twice a day; gabapentin is its older relative.

Pregabalin calms an overactive nervous system, which is why it eases nerve pain. The local insert lists euphoric mood as a common side effect. In the EU it is also registered for generalised anxiety disorder and as an add-on treatment for epilepsy. Anxiety is the kind of reason that keeps a script running for years.

Can Lyrica cause depression?

Yes, Lyrica can cause depression: its South African insert lists it as a common side effect, and the EU product information lists it among withdrawal symptoms. If low mood was part of why the script started, it can come back once the medicine goes, so with us the depression is treated alongside the dependence rather than after it.

Why did the UK make pregabalin a controlled drug in 2019?

The UK made pregabalin a Schedule 3, Class C controlled drug from 1 April 2019, after reports of misuse, dependence and deaths had grown. The MHRA, the UK medicines regulator, then held 113 reports of abuse and 98 of dependence, and the UK government’s 2018 impact assessment counted pregabalin deaths rising from 38 in 2014 to 111 in 2016. A different count, death certificates in England and Wales, named pregabalin on 617 deaths registered in 2024. South Africa keeps no equivalent count.

Can you drink alcohol on Lyrica, or take it with opioids?

No, opioids, alcohol and other sedatives do not mix safely with Lyrica. The label reports “respiratory failure, coma and deaths” in people taking it with other CNS depressant medicines. Alcohol is a sedative too, so the same caution applies to drinking on a script.

Stilpane addiction and other codeine painkillers

Codeine painkillers such as Gen-Payne, Myprodol and Stilpane are sold in South African pharmacies, and Stilpane syrup needs no prescription at all. Stilpane addiction is the one to watch: the tablets combine codeine with meprobamate, a sedative, so a daily user depends on two drugs at once, and the leaflet says Stilpane “should not be used for longer than 10 days”. Codeine syrup is also the base of lean; withdrawal, tramadol and how long it all lasts are covered in codeine withdrawal.

Benzodiazepines and tranquillisers: Xanor, Urbanol and Betapam

Xanor (alprazolam), Urbanol (clobazam) and Betapam (diazepam) are Schedule 5 sedatives, and the FDA warns dependence can follow when they are taken “steadily for several days to weeks, even as prescribed”. Stopping them abruptly can bring seizures, and pregabalin on top adds another sedative to the mix. More in benzo withdrawal.

Sleeping tablets: Stilnox (zolpidem) and zopiclone

Sleeping tablets such as Stilnox (zolpidem) and zopiclone are meant for short courses: the South African zolpidem information caps treatment at four weeks, including the taper. The effect fades after a few weeks, which is how one tablet becomes two, and stopping brings the sleeplessness back stronger, so the dose comes down on a plan.

Stimulants: Ritalin, Concerta and Vyvanse

ADHD stimulants such as Ritalin, Concerta and Vyvanse are Schedule 6 in South Africa and are misused as study aids. They work in the opposite direction to Lyrica, and the crash is the part to watch: the local information for the amphetamine Amfexa warns that severe depression may occur after misuse.

Signs of pregabalin addiction

The signs of pregabalin addiction are the same as with any prescription medicine that has started to run the day:

• Repeat scripts asked for early, or “lost”
• More than one doctor or pharmacy
• More than the prescribed dose, or doubling up on bad days
• Someone else’s capsules, or capsules bought without a script
• Hiding how much is taken
• Still taking it long after the pain has settled
• Anxious, sick or sleepless when a dose is late

A family sees less: a father asleep in front of the television early in the evening, an adult daughter whose words slur on the phone and who sounds fine the next day.

From the inside it usually feels like this: the dose on the label stopped being enough, a missed dose brings anxiety or a sick feeling, and attempts to cut down have not held. If that is where you are, do not stop suddenly on your own. Tell us what happens when you try to take less; that is the part we talk through first.

Can you come off Lyrica at home?

Often the right route is the doctor who prescribed it. If you take Lyrica as directed for pain and want to stop, that doctor can bring the dose down gradually; if you take it for epilepsy, any change to the dose belongs with your doctor, because convulsions are among the withdrawal symptoms.

Coming off at home is harder when Lyrica is one of several things you take, such as a benzo, Stilpane or daily drinking, or when earlier attempts to cut down ended with taking more. It is harder again when the anxiety, low mood or poor sleep the capsules held down comes back as the dose drops. A dose schedule alone leaves that in place. With us, a doctor examines you after you arrive, and your own counsellor works with you one-to-one every week on the anxiety or low mood under the habit.

Pregabalin withdrawal symptoms: why stopping without medical supervision is dangerous

Pregabalin withdrawal can include insomnia, headache, nausea, anxiety and diarrhoea, the South African label says, after short or long treatment alike. The EU product information adds dizziness, depression, heavy sweating, suicidal thoughts and convulsions to its list of drug withdrawal symptoms, which is why the dose should come down under medical supervision.

The label says stopping “should be done gradually over a minimum of 1 week”, and the MHRA notes that tapering “may take weeks or months”. The pace depends on the dose, how long it has been taken, and what else is in the mix.

Pregabalin with a benzodiazepine, Stilpane or daily drinking means several withdrawals at once. Do not stop suddenly on your own. Tell our team what you take, how much and for how long, and we will go through how coming off it could be planned with us; whether you need a medical detox is decided by our medical team once you have been assessed.

If you have already stopped and withdrawal has started at home, with no emergency signs such as a seizure, confusion or slow breathing, see your own doctor or a clinic today for a medical assessment. Alongside that, talk to us about a supervised detox; a WhatsApp reply from us is not medical care for a withdrawal that is already under way.

If someone taking pregabalin has a seizure, is breathing slowly or shallowly, becomes confused or cannot be woken, call local emergency services immediately and tell them everything that was taken, including alcohol. Do not wait for a WhatsApp reply.

Suicidal thoughts are on the EU withdrawal list, and if they come during a taper they need a professional’s attention soon rather than after the taper is over. If you might act on them now or cannot keep yourself safe, get emergency help immediately rather than waiting for a reply from us; the SADAG Suicide Crisis Helpline is 0800 567 567. Once you are safe, you or someone close to you can talk to us about the capsules and the low mood around them. Ruby Weber, the psychologist who heads psychology at the centre, leads the work on the depression itself.

Treatment for pregabalin addiction at Renewed Life Center

Renewed Life Center is a live-in rehab in Lakeside, a residential suburb of Cape Town, with the mountain behind the house and the beach a short drive away. Treatment for pregabalin addiction here works on two things at once: a safe way off the capsules, and the anxiety, low mood or poor sleep that kept them going.

A doctor examines you after you arrive, and if you need a detox, our medical team runs it, from three days to two weeks depending on what your body needs. With Lyrica the medicine review matters as much as the detox: Dr John Wulz, our GP, who has a background in mental health and emergency medicine, reviews the medicines you already take, such as antidepressants or painkillers, while treatment for the pain itself stays with the doctor who prescribed it. Detox alone “is not sufficient treatment”, SAMHSA says, so the programme goes on to:

• dual diagnosis care for depression, anxiety or trauma
• CBT and DBT for the thoughts and urges that reach for a capsule
• schema therapy, EMDR and TRE for older patterns and trauma
• family therapy, and a family group by video every week
• relapse prevention, with a written plan built for your home

Treatment is planned in months. In the first month you live at the centre and get safe and steady, with your own counsellor one-to-one every week and group work every weekday. The second month goes deeper into what sits underneath: the anxiety or low mood, relationships, and who you are without the capsules. Most clients stay for it. The fee depends on the programme and how long you stay; we give it on the first call and send it in writing the same day.

When you leave, sober living on the same property and an outpatient programme, if your counsellor recommends it, are there for the step home, and we keep in touch with former clients. If you fly in from abroad, we meet you at Cape Town airport.

Been on pregabalin longer than planned, or unsure how to come off it safely? Ask us how to come off it.Been on pregabalin longer than planned, or unsure how to come off it safely? Call +27 79 880 0045, free and confidential.

Asking for someone else? Read how to talk to a loved one about rehab. Nobody needs the right words: “I take more Lyrica than I should and I can’t stop” is enough.

Frequently asked questions about Lyrica and prescription drug addiction

My doctor prescribed it. Can I still be addicted?

Yes. The South African insert says dependence “may occur at therapeutic doses”. A prescription means the medicine was meant to help, not that your body has not come to need it.

Can I taper off pregabalin, benzodiazepines or sleeping tablets on my own?

No, not if you take them every day. Benzodiazepine withdrawal can be life-threatening, and pregabalin withdrawal can include convulsions. If you take Lyrica as prescribed, dose changes go through the doctor who prescribed it. If the capsules have become hard to control, message us with what you take and since when; a relative can write for you.

How long does pregabalin withdrawal last?

There is no fixed length: the label recommends stopping over a minimum of one week, and tapering from a high dose can take weeks or months.

Can you overdose on pregabalin?

Yes. Taken with an opioid or another sedative medicine, the label reports respiratory failure, coma and deaths, and alcohol is a sedative too. The MHRA has also recorded severe breathing problems with pregabalin even without opioids.

Is Stilpane addictive?

Yes. The tablets pair codeine with meprobamate, and the leaflet limits use to 10 days, so a daily habit means dependence on two drugs. Do not stop suddenly on your own: tell our team what you take, and the pace is set after a medical assessment.

Does medical aid cover pregabalin addiction treatment?

Under Prescribed Minimum Benefit 182T, medical schemes must fund hospital-based treatment for substance use for up to 3 weeks a year, the Council for Medical Schemes says, but not outpatient treatment. Schemes pay under their own rules, usually at facilities they designate, and can leave you a co-payment if you choose another centre: Discovery, for one, pays up to 80% of its rate outside its designated providers. Beyond that, what it pays depends on your scheme and option. At Renewed Life Center you pay us directly, with no claim forms; we give the fee on the first call and send it in writing the same day.