Lyrica vs. Remeron for Epilepsy and Depression: Important Differences and Potential Risks.

Key takeaways

Lyrica (pregabalin) and Remeron (mirtazapine) are both prescription medications, but they are used for different conditions and belong to different classes. Lyrica is an antiepileptic that treats nerve pain from diabetes, shingles, and spinal cord injuries, as well as fibromyalgia and partial-onset seizures. It is taken 2 or 3 times a day and can cause dizziness and drowsiness. Remeron, on the other hand, is an atypical antidepressant used to treat major depressive disorder (MDD) in adults. It is taken once daily, usually at night, and can cause sleepiness and weight gain. Lyrica is a controlled substance due to its potential for addiction, while Remeron is not. Additionally, Lyrica is available in both capsule and oral solution forms, whereas Remeron comes in oral tablets and orally disintegrating tablets. Both medications have generic versions available.

Pregabalin

(Lyrica)

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Mirtazapine

(Remeron)

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Summary for Lyrica

Prescription only

Pregabalin (Lyrica) helps treat nerve pain and fibromyalgia in adults. It can also be taken with other medications to help treat certain seizures in people 1 month and older. Pregabalin (Lyrica) comes as a capsule and oral solution in both brand-name and generic versions. The dosage depends on what condition you're treating, but it's usually taken by mouth 2 or 3 times a day. Common side effects include feeling dizzy and drowsy. This medication is a controlled substance and has interactions, like with alcohol and benzodiazepines.

Indications for Lyrica

Nerve pain from diabetes (diabetic peripheral neuropathy)
Nerve pain from shingles (postherpetic neuralgia)
Nerve pain from spinal cord injury
Fibromyalgia
Partial-onset seizures

Pros and Cons for Lyrica

Pros

An option for relieving nerve pain caused by diabetes, shingles, and spinal cord injuries
Can take with other anti-seizure medications for partial-onset seizures in people as young as 1 month of age
Available in a capsule and liquid

Cons

Can cause dizziness and drowsiness
Can cause weight gain
Is a controlled substance, so there are some rules to follow to get it filled

Common Side Effects for Lyrica

Dizziness
Drowsiness
Headache
Weight gain

Warnings for Lyrica

Allergic reactions and severe swelling
Risk of suicidal thoughts and behavior
Higher risk of side effects if you stop taking the medication too suddenly or too fast
Slowed breathing
Dizziness, sleepiness, and trouble concentrating
Swelling of the arms or legs
Weight gain
Lower platelet levels
Possible risk of muscle breakdown

Summary for Remeron

Prescription only

Mirtazapine (Remeron) is an atypical antidepressant (or more specifically, tetracyclic antidepressant). It's used to treat major depressive disorder (MDD) in adults. Mirtazapine (Remeron) is available as an oral tablet and orally disintegrating tablet (ODT) that's taken once daily, typically at night. Some common side effects of this medication include sleepiness and dry mouth. Mirtazapine (Remeron) can also raise your appetite and put you at risk for weight gain.

Indications for Remeron

Major depressive disorder (MDD) in adults

Pros and Cons for Remeron

Pros

Taken by mouth once daily
Available as a dissolvable tablet for those who can't swallow pills
Less likely to cause sexual side effects compared SSRIs
Available as a lower-cost generic

Cons

Can take up to 2 months before you feel the the full benefits
More likely than other antidepressants to cause weight gain
Can cause sleepiness
Risk of withdrawal symptoms if you suddenly stop taking it

Common Side Effects for Remeron

Sleepiness (54%)
Dry mouth (25%)
Feeling more hungry (17%)
Constipation (13%)
Weight gain (12%)
Weakness (8%)
Dizziness (7%)

Warnings for Remeron

Worsening depression, suicidal thoughts, and unusual behavior
Higher risk of infection (from low white blood cell count)
Serotonin syndrome
Withdrawal
Not for bipolar disorder
Glaucoma
Life-threatening abnormal heart rhythm (QT prolongation)
Severe allergic and skin reactions
Difficulty concentrating and extreme sleepiness
Seizures
Low blood sodium levels
Caution use in people with phenylketonuria (PKU) - orally disintegrating tablets only