Euphoria in a Capsule: The Dark Side of Pregabalin

Abstract Pregabalin, a second-generation antiepileptic with anxiolytic and analgesic properties, has seen widespread use beyond epilepsy, particularly in neuropathic pain, fibromyalgia, and anxiety disorders. However, its sedative and euphoric effects have led to increasing misuse and dependence, especially among individuals with underlying vulnerabilities. We present the case of a 27-year-old male with a 3-year history of escalating pregabalin misuse, culminating in the daily consumption of up to 1500 mg. Attempts to discontinue use resulted in classic withdrawal symptoms, including irritability, tremors, insomnia, and low mood. Following a structured detoxification regimen using chlordiazepoxide and paroxetine, the patient achieved abstinence and functional recovery. This case highlights pregabalin’s abuse potential, its reinforcing psychoactive properties, and the risk of dependence even in individuals without prior psychiatric or substance use history. As pregabalin prescriptions continue to rise, clinicians must recognize its addictive potential and adopt stricter monitoring and psychoeducation practices to mitigate misuse.