Pharmacokinetic evaluation of pregabalin for the treatment of generalized anxiety disorder

Introduction: Pregabalin is an alternative compound to SSRIs and SNRIs for the first-line treatment of generalized anxiety disorder (GAD). Areas covered: We describe the pharmacokinetic properties of pregabalin and their implications for the treatment of GAD. A search in the main database sources (Medline, ISI, Web of Knowledge and Medscape) was performed in order to obtain a comprehensive and balanced evaluation about the clinical implications of the pharmacokinetic properties of pregabalin in the treatment of GAD. The word “pregabalin” was associated with “pharmacokinetics”, “interactions”’, “GAD”, “anxiety” and “tolerability”. No restriction criteria were established in relation to methodology or publication year. Only English-language articles were selected. Expert opinion: Pregabalin is a safe and efficacious compound for GAD treatment. Short half-life (preventing persistence of side effects), absence of active metabolites and no interactions with CYP450 enzymatic system are all favorable pharmacokinetic properties for the treatment of GAD patients, including those with comorbid depressive symptoms or medical conditions. On the other hand, prescription of pregabalin should be handled with caution to minimize the incidence of renal impairment (especially in elderly patients), where a history of substance misuse or concomitant medications (e.g. anti-hypertensives or some antibiotics) are risk factors that can affect renal function.