Pregabalin: A range of misuse‐related unanswered questions

Schifano, Fabrizio; Chiappini, Stefania

doi:10.1111/cns.13115

Cited by 24 publications

(26 citation statements)

References 15 publications

(16 reference statements)

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“…Over the past 10 years, PGB migrated from being a prescription drug to a recreational drug. It gradually became more accessible via online sources or on the black market (19,(21)(22)(23)(24)(25)(26)(27)(28). PGB is often taken in combination with alcohol, BZDs, zopiclone, and gabapentin in an attempt to enhance the overall psychogenic effect.…”

Section: Pregabalin Abuse Potentialmentioning

confidence: 99%

“…Individuals with prior or current drug abuse described pleasant PGB-related experiences attained at doses far exceeding those recommended by prescription (28). One thing common to several addictive drugs is that they increase the extracellular dopaminergic activity in the mesolimbic reward system.…”

Section: Pregabalin Abuse Potentialmentioning

confidence: 99%

“…One thing common to several addictive drugs is that they increase the extracellular dopaminergic activity in the mesolimbic reward system. Different/unclear involvement of neurotransmitters and activation intensity of their receptors in cases of high/very high PGB dosage ingestion could justify the pleasant stimulation and euphoria described by users (28). PGB indeed was considered by users as an "ideal psychotropic drug" for recreational purposes, with effects similar to that of alcohol/GHB/BZDs such as entactogenic feelings and dextromethorphan-like disassociation (28).…”

Section: Pregabalin Abuse Potentialmentioning

confidence: 99%

“…venlafaxine, bupropion, quetiapine, and loperamide). PGB may induce a "liking" (euphoric high) subjective feeling, due to its GABA-mimetic action, with limited levels of "wanting"/behavioral dependence (28). On this basis, it can be hypothesized that PGB belongs to those substances with no relevant addictive power ("wanting") but could become addictive in patients with prior substance abuse experiences (29).…”

Section: Pregabalin Abuse Potentialmentioning

confidence: 99%

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Pregabalin Abuse in Combination With Other Drugs: Monitoring Among Methadone Patients

et al. 2020

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Introduction: In recent years, there has been an increase in the non-medical use of psychoactive prescription drugs including pregabalin (PGB). Studies have shown that multiple drug users and patients in methadone treatment programs administered PGB at high dosages in order to achieve euphoria, reduce withdrawal symptoms, or potentiate the effects of methadone. For these reasons, accurate toxicological monitoring is required for these high-risk individuals. Materials and Methods:The present study investigated whether PGB could be detected in the hair samples of 250 patients with a history of opiate dependency, and under toxicological surveillance assess their compliance with methadone maintenance therapy.Results: Opiates were found in 54/250 of all hair samples, while cannabis was present in 74/250 patients, cocaine was detected in 21/250 patients, and benzodiazepines without prescription were identified in 49/250 patients. As expected, methadone was present in all 250 patients (100%). PGB without prescription was found in the hair samples of 35/250 patients (14%). Of these, 91.43% were male, 48.57% were <30 y old, and 45.71% were between ages 30 and 50 y. There were no apparent associations among PGB use, daily methadone dosage, and duration of methadone maintenance therapy. Psychiatric comorbidities were present in 25.71% of the patients abusing PGB. Anxiety (55.56%) and depression (33.33%) were the most prevalent psychiatric disorders.Discussion: Most of the patients taking PGB (57.14%) used other drugs (especially opiates) concurrently. The utility of hair analysis is explained by easy and rapid sample collection and the ability of the hair to reflect long-term drug use and incorporate drug metabolites. The findings of this study suggested that PGB has significant potential for abuse by high-risk populations such as opioid users and patients with dual diagnosis. These risks are particularly high in cases of poly-drug use and drug intake that are not in compliance with prescription guidelines.

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Section: Pregabalin Abuse Potentialmentioning

confidence: 99%

Section: Pregabalin Abuse Potentialmentioning

confidence: 99%

Section: Pregabalin Abuse Potentialmentioning

confidence: 99%

Section: Pregabalin Abuse Potentialmentioning

confidence: 99%

See 2 more Smart Citations

Pregabalin Abuse in Combination With Other Drugs: Monitoring Among Methadone Patients

et al. 2020

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“…Moreover, benzodiazepines can enhance the effect of co-consumed opioids, but such co-use increases the risk of overdose through respiratory depression [33,56]. Similarly, pregabalin has been reported to cause central nervous system (CNS) depression when misused in combination with sedatives such as benzodiazepines, alcohol and opiates/opioids [57][58][59]. Our results suggest a high awareness of the NSO carfentanil; yet, most respondents were unaware of its misuse potential ( Figure 5).…”

Section: Nps Typesmentioning

confidence: 85%

Exploring the Baseline Knowledge and Experience of Healthcare Professionals in the United Kingdom on Novel Psychoactive Substances

et al. 2020

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Objective: This survey aimed to explore knowledge and experience on novel psychoactive substances (NPS) of healthcare professionals (HCPs). The study also aimed to assess how HCPs would like to improve their knowledge of NPS. Methods: Seventy paper questionnaires were disseminated in 2017 within continuing education events to pharmacists, nurses and general practitioners (GPs). Additionally, 127 online surveys were completed using the Qualtrics platform by other HCPs and mental health nurses in six United Kingdom (UK) independent mental health hospitals long-stay in-patient rehabilitation services. Two educational sessions involving pharmacists and GPs were also held in late 2017 and mid-2018. Knowledge of NPS by HCPs was evaluated prior to the start of the educational events. Evaluation forms were handed out post-sessions to garner feedback, especially on areas for improvement for future sessions. Statistical analysis of data was undertaken using SPSS (V.25). Results: Most HCPs reported only ‘basic’ to ‘intermediate’ NPS knowledge. Substance misuse service staff felt more informed, were more often consulted and had greater confidence regarding NPS compared to hospital and primary care professionals. A negative association was found between the age of the HCP and knowledge of NPS. Most participants expressed a need for regular training and updates as insufficient NPS-related information is currently received. Conclusions: An improvement within the self-reported knowledge of HCPs on NPS is evident in comparison to previous studies. Continued education of HCPs on NPS is fundamental for the provision of improved harm reduction services, which can enhance overall care for NPS service users.

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Current Evidence on Abuse and Misuse of Gabapentinoids

2020

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This review summarizes current evidence on the abuse and misuse of the gabapentinoids pregabalin and gabapentin. Pharmacovigilance studies, register-based studies, surveys, clinical toxicology studies, and forensic toxicology studies were identified and scrutinized with the goal to define the problem, identify risk factors, and discuss possible methods to reduce the potential for abuse and misuse. Studies found that gabapentinoids are abused and misused and that individuals with a history of psychiatric disorders or substance use disorder seem to be at high risk. Moreover, some evidence supports the notion that patients with opioid use disorders may be at an increased risk of abusing gabapentinoids. Available evidence also suggests that abuse and misuse are more frequent in users of pregabalin compared with users of gabapentin. Health professionals and prescribers should be aware of the risk for misuse of pregabalin and gabapentin, which eventually could lead to abuse, substance dependence, and intoxications. Prescribing to patients belonging to risk populations such as those with psychiatric disorders or substance use disorder should be avoided if possible and, if prescribed, signs of misuse and abuse should be monitored.

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Pregabalin: A range of misuse‐related unanswered questions

Cited by 24 publications

References 15 publications

Pregabalin Abuse in Combination With Other Drugs: Monitoring Among Methadone Patients

Pregabalin Abuse in Combination With Other Drugs: Monitoring Among Methadone Patients

Exploring the Baseline Knowledge and Experience of Healthcare Professionals in the United Kingdom on Novel Psychoactive Substances

Current Evidence on Abuse and Misuse of Gabapentinoids

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