Managing the misuse potential and risk of psychological harm from gabapentinoids in primary care in New Zealand

Abstract

Gabapentinoid prescribing is increasing in New Zealand. International evidence suggests that this prescribing trend is followed by increasing harms, including misuse, dependence, overdose, and psychological harms including suicidal thoughts or behaviours. However, there is limited guidance for prescribers on how to manage these potential harms. Here, we summarise the current international literature and identify three main risk factors that can be used for screening purposes when considering prescribing a gabapentinoid, to identify patients that may be at greater risk of harm. Based on current knowledge of harms, we provide guidance to prescribers on monitoring patients taking gabapentinoids. Finally, we summarise the evidence regarding tapering, and highlight key knowledge gaps including other interventions, referral, and data from primary care populations.

Primary care: The central function and main focus of the health system

“…11 The competition organisers, Associate Professor Hamish Wilson and Alexa Gilbert-Obrart, introduce these essays and comment on the importance of 'storytelling' in developing professionalism among medical students. 11 A Viewpoint articles provides an overview of the use, mis-use and best management of gabapentinoids 12 and another makes a case for more gender-specific research in diabetes care. 13 Gabapentinoid use is increasing, often for unapproved indications.…”