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Gabapentin and pregabalin (Lyrica) continue to surge as an alternative to opiods for pain.  They are best prescribed for post herpetic neuralgia and diabetic neuropathy.  Efficacy may be similar to Seretonin Reuptake Inhibitors.  Tricyclic antidepressants may be more effective but have far more side effects. However, there is no good evidence for its use for chronic back pain or sciatica.  Gabapentinoids such as Lyrica and gabapentin also considered to be euphoric drugs which can lead to misuse and abuse.  in fact some states classify these drugs as considered category 5  controlled substances.  Then there is the argument of cost. The  dose of Lyrica is twice a day and gabapentin is three times a day.  Monthly cost of Lyrica is $800 a month as supposed to $40 per month for gabapentin with no significant difference in efficacy.

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