Pregabalina w leczeniu zaburzeń lękowych i bólu neuropatycznego Artykuł przeglądowy
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Abstrakt
Pregabalina jest lekiem o nietypowym mechanizmie działania (ligand dodatkowej podjednostki α2δ zależnych od potencjału błonowego kanałów wapniowych), początkowo zarejestrowanym do leczenia padaczki. Liczne badania porejestracyjne pokazały, że lek ma duży potencjał działania w innych wskazaniach i może być cennym uzupełnieniem dostępnych opcji terapeutycznych, szczególnie w zespole lęku uogólnionego oraz bólu neuropatycznym (dotyczy to zwłaszcza neuropatii cukrzycowej, neuropatii po półpaścu oraz ośrodkowym bólu neuropatycznym). Innym ciekawym wskazaniem do stosowania pregabaliny jest fibromialgia. Pregabalina jest na ogół lekiem dobrze tolerowanym, a do jej najczęstszych działań niepożądanych należą: senność, astenia, zawroty głowy, obrzęk obwodowy oraz przyrost masy ciała. Lek praktycznie nie ulega metabolizmowi wątrobowemu i nie wiąże się z białkami osocza, co skutkuje minimalnym potencjałem interakcji farmakokinetycznych. Jest wydalany praktycznie w całości przez nerki, wymaga dostosowania dawkowania u chorych z niewydolnością nerek. Zarówno w zespole lęku uogólnionego, jak i w bólu neuropatycznym pregabalina może być skuteczna w monoterapii i w terapii łączonej (np. z SNRI).
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