A Call for Caution in Prescribing Gabapentin to Individuals With Concurrent Polysubstance Abuse: A Case Report

Martínez, Gabriel García; Olabisi, Jendayi; Ruekert, Laura; Hasan, Syed Saud

doi:10.1097/pra.0000000000000403

Cited by 5 publications

(2 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is still not very apparent in France ( 13 ); this discrepancy could be due to the level of use, which is about four times lower for gabapentin than pregabalin. Moreover, geographical variations must be interpreted with caution and could be partly explained by the health professionals' awareness regarding the abuse potential of these drugs ( 37 – 39 , 59 – 61 ).…”

Section: Discussionmentioning

confidence: 99%

Gabapentinoid Abuse in France: Evidence on Health Consequences and New Points of Vigilance

et al. 2021

View full text Add to dashboard Cite

Introduction: Gabapentinoid drugs (gabapentin and pregabalin) are widely used worldwide for epileptic and pain disorders. First signals of gabapentinoid abuse occurred in the last decade. This study aims to describe clinical characteristics of gabapentinoid use related disorders and health consequences in France.Materials and Methods: We designed a multisource investigation reviewing data reported to the French Addictovigilance Network (FAN) with pregabalin and gabapentin from 2010 to 2019. Information was obtained through the analysis of Spontaneous Reports (SRs) notified by health professionals and the pharmacoepidemiological surveys OSIAP (suspicious prescriptions forms indicators of potential abuse), OPPIDUM (observation of illicit drugs and misuse of psychotropic medications), DRAMES (death related to prescription drugs and other substances), and DTA (toxic deaths due to analgesics).Results: Over 2010–2019 period, were collected: (i) 265 SRs (258 pregabalin; 7 gabapentin); (ii) 816 forged prescription forms (805 pregabalin, 10 gabapentin, 1 involving both drugs); (iii) 145 cases of gabapentinoid use in people who use drugs (121 pregabalin; 24 gabapentin) and (iv) 31 cases of gabapentinoid-related deaths (25 pregabalin; 6 gabapentin). Risk factors of gabapentinoid abuse were opioid use disorders or psychiatric history, but cases of primary abuse in subjects without any substance abuse history were observed. Adverse outcomes concern almost exclusively pregabalin, with coma, dyspnea, convulsion, and conduction disorders. Treatment demands increased from 10.6% in 2018 to 23.1% in 2019, with pregabalin cited as the first substance leading to addictological care in the 2019 OPPIDUM survey. Gabapentinoid-related deaths increased over time. Pregabalin has become the first drug mentioned in forged prescriptions in 2019 (23.8% of OSIAP), while it ranked at the 15th position in 2017 (2.6%).Discussion: This study shows the importance of addictovigilance monitoring for gabapentinoids. Addictovigilance data helped to make visible the gabapentinoid-abuse related health harms (hospitalization for serious neurologic, psychiatric or cardiac effects, requests for addictological support and deaths) and to confirm the intrinsic abuse potential of pregabalin. These data highlight new points of vigilance considering observed primary abuse. At this point in France, the risk of abuse and related complications is very apparent with pregabalin. Still, it is identical to that observed elsewhere with gabapentin.

show abstract

Section: Discussionmentioning

confidence: 99%

Gabapentinoid Abuse in France: Evidence on Health Consequences and New Points of Vigilance

et al. 2021

View full text Add to dashboard Cite

show abstract

“…25 (2) Gabapentin is structurally similar to pregabalin, and several case reports describe a similar abuse tendency to pregabalin; therefore, gabapentin administration needs to be closely monitored in patients who abuse drugs. 26 (3) Sodium channel and some calcium channel blockers such as gabapentin should not be administered to patients with generalized epilepsies because of the risk of increased absences and myoclonia. Our patient presents generalized spike and wave discharges and thus is at risk of developing generalized seizures.…”

Section: Clinical Relevance Of the Findingsmentioning

confidence: 99%

Epileptic Spikes in EEG and Migraine Attacks in the Course of Cannabis Withdrawal: A Case Report

Adorjan¹,

Chrobok²,

Koller³

et al. 2019

Clin EEG Neurosci

View full text Add to dashboard Cite

In psychiatry, routine EEGs are often abnormal and not very specific, raising questions about the clinical relevance and consequences of potential anomalies. One such question is whether the administration of anticonvulsants would be useful if epileptic discharges are detected in patients without any clinical correlates. With regard to this question, we present a case study in which abnormal EEG patterns were observed in a patient with chronic migraine and cannabis addiction. The patient was a 34-year-old woman with a 14-year history of cannabis abuse who, during withdrawal, showed epileptic spikes, without any corresponding clinical symptoms, and migraine attacks of increasing intensity and frequency. This case study is in line with the new DSM-5 diagnostic tool that for the first time includes the diagnosis of cannabis withdrawal.

show abstract

Abuse and Misuse of Pregabalin and Gabapentin: A Systematic Review Update

Evoy

Sadrameli

Contreras

et al. 2020

Drugs

137

122

View full text Add to dashboard Cite

A Call for Caution in Prescribing Gabapentin to Individuals With Concurrent Polysubstance Abuse: A Case Report

Cited by 5 publications

References 19 publications

Gabapentinoid Abuse in France: Evidence on Health Consequences and New Points of Vigilance

Gabapentinoid Abuse in France: Evidence on Health Consequences and New Points of Vigilance

Epileptic Spikes in EEG and Migraine Attacks in the Course of Cannabis Withdrawal: A Case Report

Abuse and Misuse of Pregabalin and Gabapentin: A Systematic Review Update

Contact Info

Product

Resources

About