Trends in gabapentin and baclofen exposures reported to U.S. poison centers

Oral baclofen toxicity in older patients with chronic kidney disease

“…5 Primary guidance for medications to avoid in older patients comes from the 2019 AGS-Beers list, [6][7][8] in which baclofen was not addressed. With recent baclofen reports to US poison control centers increased by 36.2%, 10 we examined the association of diminished renal function with hospitalizations, falls, and confusion in older patients prescribed baclofen.…”

Coprescription of Opioids With Other Medications and Risk of Opioid Overdose

“…Over the last 20 years, opioid overdose deaths involving other drug classes have also increased; most commonly, benzodiazepines were involved in 33% of all prescription opioid overdose deaths in 2017 7,8 . Gabapentinoids and muscle relaxants have also been prescribed with opioids to optimize pain relief, but concurrent use has been associated with opioid overdose 9–13 . Aside from these CNS‐depressing medications, little evidence is available regarding the clinical relevance of interactions involving other drug combinations that may increase opioid overdose risk 14 .…”

Response to Comment on “Gabapentinoid Benefit and Risk Stratification: Mechanisms Over Myth”

“…When considering mortality statistics, as pointed out in our article, during a 15-year period (2000-2014) of data collection by the American Association of Poison Control Centers [25], deaths attributed to antidepressants (n [ 300) were two orders of magnitude greater than deaths from GPNs (n = 8). A more recent investigation of gabapentin toxicity numbers reported to the U.S. National Poison Data System between 2013 and 2017 identified 17 deaths where gabapentin was involved [26]. While every individual death is a tragedy that may or may not be attributable to GPNs, the question of safety from a public health standpoint again really boils down to a question of scale-the denominator numbers in the hundreds of millions (if not billions) of prescriptions.…”