Abstract:Pregabalin are widely used in neurology, psychiatry and primary healthcare for a range of clinical conditions but are increasingly being reported as possessing a potential for misuse. In fact, increasing levels of both prescriptions and related fatalities, together with an anecdotally growing black market, have been reported in Jordan.
Objectives:The aim of the study was to identify and assess cases of Pregabalin misuse or dependence as reported to the Jordanian Mental health care clinics database, to identify the magnitude of this problem and the characteristics of these reactions and reviews the current evidence base of this potential, in an attempt to answer the question of whether there is cause for concern about this drug.
Methods:All spontaneous reports of Pregabalin -(2016-2017) related misuse/abuse/dependence were retrieved. A descriptive analysis by source, sex, age, and type of report was performed.
Introduction:Potent binding of pregabalin at the calcium channel results in a reduction in the release of excitatory molecules. Furthermore, gabapentinoids are thought to possess GABA-mimetic properties whilst possibly presenting with direct/indirect effects on the dopaminergic 'reward' system. Overall, pregabalin is characterized by higher potency, quicker absorption rates and greater bioavailability levels than other gabapentinoids. Although at therapeutic dosages gabapentinoids may present with low addictive liability levels, misusers perceptions for these molecules to constitute a valid substitute for most common illicit drugs may be a reason of concern. Gabapentinoid experimenters are profiled here as individuals with a history of recreational polydrug misuse, who self-administer with dosages clearly in excess (e.g. up to 3-20 times) of those that are clinically advisable. Physicians considering prescribing gabapentinoids for neurological/psychiatric disorders should carefully evaluate a possible previous history of drug abuse, whilst being able to promptly identify signs of pregabalin misuse and provide possible assistance in tapering off the medication.
Pregabalin is a medication used extensively in neurosurgery and mental health care as it is sometimes used in primary health care in medical conditions but is increasingly reported as a potential increase of use leads to misuse and abuse. The fact, increase both levels of abuse and death; along with the growing non-medical use through black market have been reported in Jordan.
According to the Centers for Disease Control and Prevention (CDC), depression affects about 1%-5% of the general elderly population, 13.5% in elderly who require home healthcare, and 11.5% in older hospital patients” CDC, 2017. Depression in the elderly is accompanied by functional weakening and early death due to suicide and other causes, Symptoms may include sadness; lack of interest, power, and ability to concentrate; insomnia and decreased appetite; and co-disease. Elderly patients have a lower response to antidepressant medications than adult patients.
The use of antidepressants and sedative drugs is the best treatment proved for major depressive disorder and in some cases the electrical convulsion therapy. The use of stimulants off-label in clinical practice an increasing concern as there is no research evidence to support their effectiveness.
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