There are two previously reported cases describing the management of pregabalin self-poisoning and one further case of management of therapeutic pregabalin accumulation. The peak reported pregabalin concentrations in these cases ranged from 13 mg/L to approximately 60 mg/L. Previous case reports have suggested that both supportive care and enhanced elimination are appropriate managements for pregabalin toxicity. A 54-year-old male presented following ingestion of 8.4 g of pregabalin. Initially, he had no clinical features of toxicity, although he developed significant neurological depression and coma approximately 3 h post-ingestion. He was managed with supportive care (including endotracheal intubation and mechanical ventilation) until his level of consciousness improved. Subsequent toxicological screening confirmed isolated pregabalin ingestion, with a serum pregabalin concentration of 66.5 mg/L at the time he clinically deteriorated. The pharmacokinetic properties of pregabalin indicate the potential value of extra-corporeal elimination methods such as haemodialysis. Clinical toxicologists should be aware that whilst there is a pharmacokinetic basis for the use of extra-corporeal methods in those with severe toxicity arising from excessive plasma pregabalin concentrations, there are case reports, including this one, where patients have been managed with supportive measures only.

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A specialist in ophthalmology, she was also a brilliant, all‐round ‘supervet’, who thrived on keeping fit and enjoying outdoor pursuits.

Green Light was developed to enable service providers to implement the National Service Framework for Mental Health (NSF MH), and asks how good your mental health services are for people with a learning disability. A multi‐agency user and carer project in Hampshire has evaluated and improved the quality of existing service provision for adults with learning disabilities who also have a mental health problem.

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A brave vet who threw her energy into dealing positively with everything that was placed in her way.