Many studies have investigated the effectiveness and safety of different doses of pregabalin in fibromyalgia. However, its optimal dosage remains controversial. 

A recent study thus conducted a Bayesian network meta-analysis comparing 300, 450, and 600 mg/daily of pregabalin for fibromyalgia. It conducted a literature search in January 2022 and accessed all the double-blind, randomized clinical trials comparing two or more dose protocols of pregabalin for fibromyalgia. 

It excluded studies enrolling less than 50 patients or with a length of follow-up shorter than eight weeks. It looked for Fibromyalgia Impact Questionnaire (FIQ), sleep quality, and adverse events. 

The study retrieved the data from 4693 patients (mean age 48.5 years). 93.1% of which were women. The median follow-up was 14.8 weeks. Pregabalin 450 mg/day showed a greater reduction in Fibromyalgia Impact Questionnaire, while Pregabalin 600 demonstrated the greatest sleep quality and Pregabalin 300 mg/daily evidenced the lowest rate of adverse events. 

This study highlights the importance of customizing the dose of pregabalin according to patients characteristics and main symptoms.

Migliorini F, Mafulli N, Knobe M, Tenze G, Aljalloud A, Colarossi G. Pregabalin administration in patients with fibromyalgia: a Bayesian network meta‑analysis. Scientific Reports.2022; 12:12148. https://doi.org/10.1038/s41598-022-16146-x