Pregabalin-associated acute psychosis and epileptiform EEG-changes

Olaizola, Itziar; Ellger, Tanja; Young, Peter; Bösebeck, Frank; Evers, Stefan; Kellinghaus, Christoph

doi:10.1016/j.seizure.2006.02.004

Cited by 33 publications

(15 citation statements)

References 6 publications

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“…The first reports of PGB abuse and dependence appeared in 2006 and involved cases from Italy, Germany, and Turkey (14)(15)(16)(17)(18)(19). Many cases of PGB abuse have been reported by the Scandinavian, British, French, and German pharmacovigilance systems since 2008, most of which described patients currently or formerly dependent on other such substances (7).…”

Section: Pregabalin Abuse Potentialmentioning

confidence: 99%

Pregabalin Abuse in Combination With Other Drugs: Monitoring Among Methadone Patients

et al. 2020

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Introduction: In recent years, there has been an increase in the non-medical use of psychoactive prescription drugs including pregabalin (PGB). Studies have shown that multiple drug users and patients in methadone treatment programs administered PGB at high dosages in order to achieve euphoria, reduce withdrawal symptoms, or potentiate the effects of methadone. For these reasons, accurate toxicological monitoring is required for these high-risk individuals. Materials and Methods:The present study investigated whether PGB could be detected in the hair samples of 250 patients with a history of opiate dependency, and under toxicological surveillance assess their compliance with methadone maintenance therapy.Results: Opiates were found in 54/250 of all hair samples, while cannabis was present in 74/250 patients, cocaine was detected in 21/250 patients, and benzodiazepines without prescription were identified in 49/250 patients. As expected, methadone was present in all 250 patients (100%). PGB without prescription was found in the hair samples of 35/250 patients (14%). Of these, 91.43% were male, 48.57% were <30 y old, and 45.71% were between ages 30 and 50 y. There were no apparent associations among PGB use, daily methadone dosage, and duration of methadone maintenance therapy. Psychiatric comorbidities were present in 25.71% of the patients abusing PGB. Anxiety (55.56%) and depression (33.33%) were the most prevalent psychiatric disorders.Discussion: Most of the patients taking PGB (57.14%) used other drugs (especially opiates) concurrently. The utility of hair analysis is explained by easy and rapid sample collection and the ability of the hair to reflect long-term drug use and incorporate drug metabolites. The findings of this study suggested that PGB has significant potential for abuse by high-risk populations such as opioid users and patients with dual diagnosis. These risks are particularly high in cases of poly-drug use and drug intake that are not in compliance with prescription guidelines.

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Section: Pregabalin Abuse Potentialmentioning

confidence: 99%

Pregabalin Abuse in Combination With Other Drugs: Monitoring Among Methadone Patients

et al. 2020

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“…A systematic review of randomized controlled trials, documented the most common side effects of pregabalin including dizziness, vertigo, incoordination, balance disorder, ataxia, diplopia, blurred vision, tremor, drowsiness, confusion, disturbance of attention, euphoria, disorganized thinking and fatigue [8]. Adverse reactions occur more often at high doses and pregabalin has been associated with psychosis, hallucinations and other neuropsychiatric symptoms when titrated rapidly [9,10]. In contrast to these studies which suggest that visual hallucinations from pregabalin are mainly attributed to rapid titration, our study indicates that this side effect may be dose depended and can appear in cases of slow titration as well, as happened in our case.…”

Section: Discussionmentioning

confidence: 99%

Pregabalin induced visual hallucinations – a rare adverse reaction

Mousailidis

Papanna

Salmon

et al. 2020

BMC Pharmacol Toxicol

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Background: Pregabalin is an anticonvulsive, analgesic and anxiolytic medication. The typical side effects include dizziness, somnolence and weight gain. Few studies or case reports have demonstrated psychiatric side effects resulting from its use. Case presentation: We present a patient who suffered visual hallucinations and agitation associated with an increase in pregabalin dose, resolving completely after pregabalin discontinuation.Conclusions: Acute visual hallucinations should be considered in the clinical spectrum of very rare side effects of pregabalin use, especially at higher doses. Tapered discontinuation of the medication can improve and resolve symptoms.

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“…It seems possible that the thermoregulatory center in the hypothalamic pre-optic area may be affected by spreading epileptic activity, and thus cause elevated body temperature [3][4][5] . The mesial temporal lobe structures have extensive connections with the neuroendocrine hypothalamus portion, and a discharging temporal focus can possibly alter hypothalamic function 3 .…”

Section: Discussionmentioning

confidence: 99%