Misuse of the γ‐aminobutyric acid analogues baclofen, gabapentin and pregabalin in the UK

Kapil, Vikas; Green, Jody L.; Lait, Marie-Claire Le; Wood, David M.

doi:10.1111/bcp.12277

Cited by 84 publications

(71 citation statements)

References 4 publications

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“…a powerful benzodiazepine compound that may be misused; [25]), seem to anecdotally possess both sedative as well as dissociative/psychedelic effects [10]. This may be considered an observation that is in apparent contrast with gabapentinoids, similar to benzodiazepines, being GABA analogues only [26]. With a relatively short half-life of about 6 h, gabapentinoids are mostly ([98 %) excreted unchanged in the urine [15], with a urine specimen being positive for pregabalin for up to 5-6 days after intake in subjects with normal renal function [2].…”

Section: Methods/literature Search Strategymentioning

confidence: 99%

“…Similarly, Dyrkorn et al [32] carried out in Norway a nationwide drug screening investigating 1,854 urine specimens, managing to identify pregabalin in 4.5 % of these samples. Finally, in a UK-based, anonymous, 1,500-respondent, online survey, Kapil et al [26] compared misuse of baclofen, gabapentin and pregabalin. Respondents' self-reported lifetime prevalence of gabapentin misuse (1.1 %) was similar to pregabalin (0.8 %) and baclofen (1.3 %), in contrast with an alleged lifetime prevalence of cocaine and cannabis use, respectively, of 8.1 and 28.1 %.…”

Section: General Population Surveysmentioning

confidence: 99%

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Misuse and Abuse of Pregabalin and Gabapentin: Cause for Concern?

2014

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Gabapentinoids (e.g. pregabalin and gabapentin) are widely used in neurology, psychiatry and primary healthcare 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 from a range of countries. This article reviews the current evidence base of this potential, in an attempt to answer the question of whether there is cause for concern about these drugs. Potent binding of pregabalin/gabapentin 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 gabapentin. 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/gabapentin misuse and provide possible assistance in tapering off the medication. Key pointsGabapentinoids are thought to possess GABAmimetic properties, whilst possibly presenting with direct/indirect effects on the dopaminergic 'reward' system.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 for a possible previous history of drug abuse, whilst being able to promptly identify signs of pregabalin/gabapentin misuse and provide possible assistance in tapering off the medication.

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Section: Methods/literature Search Strategymentioning

confidence: 99%

Section: General Population Surveysmentioning

confidence: 99%

Misuse and Abuse of Pregabalin and Gabapentin: Cause for Concern?

2014

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“…Although gabapentinoids at therapeutic dosages may present with a low addictive liability potential, misusers may ingest these molecules to achieve euphoric and dissociative effects similar to those of traditional recreational drugs [9][10][11][12][13][14][15].…”

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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“…These patients reported a nonmedical use of the drug, mainly to be high or to manage methadone doses [10]. Finally, an online survey in a sample of 1500 individuals in the UK, found a lifetime prevalence of pregabalin misuse of 0.5 % [11]. In addition, a Norwegian study found 11 and 13 cases of pregabalin abuse, respectively, in a question-answer pair database and the Norwegian Adverse Drug Reactions Database [12].…”

Section: Introductionmentioning

confidence: 99%

Disproportionality Analysis for the Assessment of Abuse and Dependence Potential of Pregabalin in the French Pharmacovigilance Database

Bossard

Ponté²,

Dupouy

et al. 2016

Clin Drug Investig

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The first cases of pregabalin-related abuse or dependence reported in France occurred later than in other European countries, since none had been described before 2010. This analysis in the FPVD did not find a higher proportion of abuse/dependence with pregabalin in comparison with other drugs. Considering evidence of pregabalin abuse worldwide, this analysis underlines the limitations of spontaneous reporting system in the field of addictovigilance.

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Misuse of the γ‐aminobutyric acid analogues baclofen, gabapentin and pregabalin in the UK

Cited by 84 publications

References 4 publications

Misuse and Abuse of Pregabalin and Gabapentin: Cause for Concern?

Misuse and Abuse of Pregabalin and Gabapentin: Cause for Concern?

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

Disproportionality Analysis for the Assessment of Abuse and Dependence Potential of Pregabalin in the French Pharmacovigilance Database

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