Pregabalin or Lyrica® is currently FDA approved for partial onset seizures, neuropathic pain from post-herpetic neuralgia and diabetic neuropathy, as well as fibromyalgia. Lyrica works by binding to the subunit of a voltage-gated calcium channel in the brain and spinal cord. This reduces flow of calcium into the axon during depolarization (firing) of the neuron thereby reducing neurotransmitter release from that neuron.
In the use of epilepsy, the medication is a relatively inexpensive add-on therapy for partial onset seizures. The doses required for epilepsy tend to be higher than other indications and at these doses there is a significant incidence of swelling of the legs and weight gain, which limits its use. Although the mechanism of action is the same as gabapentin, its absorption is superior and this allows it to be a useful antiepileptic medication.