There are several things to unpick in what Liza is saying. The first, and probably the most practical, is that if she does want to give the pregabalin a go, the prescription is only valid for 28 days from the date it bears. This is because pregabalin, alongside gabapentin, became a Schedule 3 controlled drug earlier this year subject to all normal requirements except safe custody. This also means that no more than 30 days’ treatment should be prescribed, though note that this is a good practice recommendation rather than a legal requirement.

In terms of side effects, the best thing to do is for Vicky to talk Liza through a pregabalin leaflet, explaining the difference between those listed under “common”, “uncommon” and “rare”, and so on, and providing context and perspective through comparison with the leaflet of a medicine she is more familiar with. She should also advise on the potential for central nervous system (CNS) depression with other drugs that also cause this side effect, particularly opioids and alcohol.

When it comes to dependence, pregabalin and gabapentin are certainly associated with the potential for abuse and addiction. There are various risk factors for this, which the GP should have considered, and hence drugs of this nature should be started at a low dose and titrated up to the minimum effective dose and taken for the shortest amount of time necessary, a process that will be facilitated if Liza is being seen by the GP regularly.

However, it is worth bearing in mind that pregabalin has been shown to be effective at reducing neuropathic pain, which is what Liza seems to be experiencing as a result of the slipped disc in her spine compressing one of the nerve roots, and given the lack of success she has had with other medication and the pain she is in, it may be worth trying.