Pregabalin Dependence: A Case Report

Aldemir, Ebru; Altıntoprak, Ayşe Ender; Çoşkunol, Hakan

doi:10.5080/u7746

Cited by 9 publications

(11 citation statements)

References 13 publications

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“…History of substance misuse is typically associated with overuse of pregabalin [23][24][25][26]. Although tolerance to pregabalin has not been proven [27,28], its withdrawal syndrome may include agitation/ anxiety, craving, sweating, insomnia, fatigue, palpitations, tremors, and diarrhea [29][30][31][32][33].…”

Section: Introductionmentioning

confidence: 99%

A Decade of Gabapentinoid Misuse: An Analysis of the European Medicines Agency’s ‘Suspected Adverse Drug Reactions’ Database

2016

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Section: Introductionmentioning

confidence: 99%

A Decade of Gabapentinoid Misuse: An Analysis of the European Medicines Agency’s ‘Suspected Adverse Drug Reactions’ Database

2016

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“…with low potential for developing addiction) in the United States according to Controlled Substance Act Scheduling [22]. Despite this early knowledge, in recent years, there are data on the potential for abuse or addiction in patients with a history of opioid abuse or those with current opioid addiction, and there have been increasing numbers of case reports showing examples of pregabalin abuse and addiction [8][9][10][11][12][13][14][15][16].…”

Section: Discussionmentioning

confidence: 99%

“…There are data and increasing numbers of case reports on the increased potential for abuse or addiction of pregabalin, a widely used drug with many indications, in patients with a history of opioid abuse or current opioid addiction [8][9][10][11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Pregabalin abuse among patients with opioid use disorders may increase the severity of withdrawal symptoms: a single-center, case-control study

Şahiner

Erzın

Ocak

et al. 2019

Psychiatry and Clinical Psychopharmacology

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OBJECTIVE: Opioid addiction is a disease that is increasing in our country, Turkey, and around the world, which it is difficult to treat in medical, social, and economic terms. Pregabalin is a preparation used for the treatment of epilepsy, neuropathic pain, and anxiety disorders. In opioid users, pregabalin is increasingly being self-administered off-label due to its euphoria effect at high doses. We investigated the effects of pregabalin on addiction profile and opioid withdrawal severity by comparing patients with opioid addiction who were and were not using off-label pregabalin. METHODS: Between July and August 2016, a total of 120 patients (60 patients were pregabalin users and 60 patients were non-users) who presented to Ankara Numune Training and Research Hospital Psychiatry Clinic Alcohol and Substance Addiction Treatment Center and were diagnosed with opioid use disorder according to the DSM-5, were included in the study. Patients who were using other substances were excluded from the study. A sociodemographic data form, the Clinical Opiate Withdrawal Scale, and Addiction Profile Index (API) were applied to the patients. RESULTS: There was no statistically significant difference between pregabalin users and pregabalin non-users in terms of age, sex, age of onset, working status, and whether previous treatment had been received. In the pregabalin user group, the severity of opioid withdrawal, API substance use characteristics, diagnosis, effects on life, craving, motivation subscale scores, and API total score were found to be significantly higher than in the nonuser group. CONCLUSION: Off-label pregabalin use among patients with opioid addiction is becoming more common. Off-label, high-dose pregabalin use may worsen existing opioid addiction, create a new area of addiction, and an illegal market. Highlights. We aimed to investigate the effects of pregabalin on addiction profile and opioid withdrawal severity by comparing patients with opioid addiction who were and were not using off-label pregabalin. . In the pregabalin user group, the severity of opioid withdrawal, and API total score were found to be significantly higher than in the non-user group. . The use of off-label, high-dose pregabalin may worsen existing opioid addiction. ARTICLE HISTORY

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“…The European Summary of Product Characteristics notes that “Cases of misuse, abuse and dependence have been reported” [25], while in the USA, pregabalin is listed as a Schedule V drug, denoting a low potential for abuse and misuse relative to opioids, stimulants, benzodiazepines, and other Schedule I–IV drugs. A misuse/abuse potential of pregabalin has been reported in multiple epidemiological studies including drug utilization studies [65–68], adverse drug reaction reports [69–73], postmortem reports [74–76], and studies in populations with a previous history of other substance misuse or abuse [77–80], as well as in multiple case studies [81–92]. Results from controlled clinical studies have reported AEs suggestive of a potential for misuse or abuse, notably euphoria, which has an incidence of 4% across all approved indications [26].…”

Section: Discussionmentioning

confidence: 99%

Pregabalin for the Treatment of Drug and Alcohol Withdrawal Symptoms: A Comprehensive Review

et al. 2016

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Treatments for physical dependence and associated withdrawal symptoms following the abrupt discontinuation of prescription drugs (such as opioids and benzodiazepines), nicotine, alcohol, and cannabinoids are available, but there is still a need for new and more effective therapies. This review examines evidence supporting the potential use of pregabalin, an α2δ voltage-gated calcium channel subunit ligand, for the treatment of physical dependence and associated withdrawal symptoms. A literature search of the MEDLINE and Cochrane Library databases up to and including 11 December 2015 was conducted. The search term used was ‘(dependence OR withdrawal) AND pregabalin’. No other date limits were set and no language restrictions were applied. Works cited in identified articles were cross-referenced and personal archives of references also searched. Articles were included based on the expert opinions of the authors. There is limited evidence supporting the role of pregabalin for the treatment of physical dependence and accompanying withdrawal symptoms associated with opioids, benzodiazepines, nicotine, cannabinoids, and alcohol, although data from randomized controlled studies are sparse. However, the current evidence is promising and provides a platform for future studies, including appropriate randomized, placebo- and/or comparator-controlled studies, to further explore the efficacy and safety of pregabalin for the treatment of withdrawal symptoms. Given the potential for pregabalin misuse or abuse, particularly in individuals with a previous history of substance abuse, clinicians should exercise caution when using pregabalin in this patient population.

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Pregabalin Dependence: A Case Report

Cited by 9 publications

References 13 publications

A Decade of Gabapentinoid Misuse: An Analysis of the European Medicines Agency’s ‘Suspected Adverse Drug Reactions’ Database

A Decade of Gabapentinoid Misuse: An Analysis of the European Medicines Agency’s ‘Suspected Adverse Drug Reactions’ Database

Pregabalin abuse among patients with opioid use disorders may increase the severity of withdrawal symptoms: a single-center, case-control study

Pregabalin for the Treatment of Drug and Alcohol Withdrawal Symptoms: A Comprehensive Review

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