# A client taking pregabalin 150 mg twice daily for 8 months for fibromyalgia tells the nurse she plans to stop the medication abruptly because she feels better. Which is the nurse's best teaching?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391753&lang=en  
> language: en  
> subject: Medical Emergencies  
> category: PA

## Question

A client taking pregabalin 150 mg twice daily for 8 months for fibromyalgia tells the nurse she plans to stop the medication abruptly because she feels better. Which is the nurse's best teaching?

## Option

1. "Pregabalin should be tapered gradually over at least 1 week to avoid withdrawal symptoms such as insomnia, anxiety, headache, and seizures." **✔ Correct answer**
2. "Switch to taking the medication only when you feel pain."
3. "Double the dose for one week, then stop completely."
4. "You can stop the medication today since you feel better."

**Correct answer: 1**

## Explanation

Correct (2): Pregabalin (and gabapentin) cause physical dependence with chronic use; abrupt discontinuation can cause withdrawal symptoms — anxiety, insomnia, sweating, nausea, headache, and rarely seizures. Standard practice is gradual taper over at least 1 week (longer for higher doses or longer duration). (1,3,4) Unsafe approaches.

## In-depth explanation

Memory Tip Gabapentinoids = "Taper to Stop" — even non-controlled gabapentin requires gradual reduction. CPG Pregabalin is a Schedule V controlled substance because of dependence potential.

## Clinical scenario

Scenario 45-year-old female on pregabalin 150 mg PO BID × 8 months for fibromyalgia, asking to stop abruptly today.

## Key concepts

- **Pregabalin** — Schedule V controlled gabapentinoid; treats fibromyalgia, neuropathic pain, and seizures.
- **Gradual taper** — Step-wise dose reduction over days to weeks to prevent withdrawal; standard for chronic gabapentinoid users.
- **Physical dependence** — Physiologic adaptation requiring continued use to avoid withdrawal; distinct from addiction.

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