Pregabalin as adjunctive therapy in benzodiazepine discontinuation

Caniff, Kaylee E; Telega, Emily; Bostwick, Jolene R.; Gardner, Kristen N.

doi:10.2146/ajhp160712

Cited by 10 publications

(5 citation statements)

References 15 publications

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Section: Discussionmentioning

confidence: 99%

“…Also, in some countries, gabapentinoids might replace partially benzodiazepines; in Spain, a general population survey performed every 2 years, showed data on life-time NMU of benzodiazepines about 3.0% in male and 3.1% in female (26). Some studies have tried to analyze the possible usefulness of pregabalin and gabapentin in the treatment of benzodiazepine use disorder, but there are no clear results regarding this (27,28). When evaluating the rates by drug, as described before, pregabalin has more endorsements than gabapentin, for example, in a recent paper describing data from addictovigilance monitoring for gabapentinoids (24).…”

Section: Discussionmentioning

confidence: 99%

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Non-medical Use of Prescription Gabapentinoids (Gabapentin and Pregabalin) in Five European Countries

et al. 2021

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Background: Non-medical use (NMU) of prescription GABA analogs (pregabalin and gabapentin) has been reported especially in opiate dependent persons. However, by now the prevalence of NMU of gabapentinoids in the general population has not been sufficiently evaluated. The aim of this research paper is to determine the prevalence of prescription GABA analog NMU and associated demographics in five European countries with special detail of Spain.Methods: The RADARS Survey of Non-Medical Use of Prescription Drugs Program (NMURx) is a harmonized series of contemporaneous cross-sectional surveys of adults conducted in multiple countries. NMURx collects data from the general population in each participating country about NMU of prescription drugs, illicit drugs, and associated demographics. NMU was defined as “using a medication without a doctor's prescription or for any reason other than what was recommended by their doctor.” Responses from Spain (4Q2017, n=10,062) were analyzed in detail. Comparative data were available from France, Germany, Italy, and UK. Responses were collected using non-probability quota sampling and post-stratification population weighting was applied to reflect the national distributions of adults, based on age, gender, and census region. Rates of NMU and associated demographics were reported as rate of past 90-day NMU per 100,000 adult population with 95% confidence intervals.Results: Germany (1,197 per 100,000 adult population [95% CI: 1,004.3–1,379.1]) and United Kingdom (1,067 per 100,000 adult population [95% CI: 851.3–1,283.2]) presented the highest prevalence of gabapentinoids NMU. In Spain the prevalence of past 90 days GABA analog NMU was: 344.4, 95% (CI 204.8–484.0), with male predominance. Those who non-medically use GABA analogs had a higher prevalence of lifetime chronic pain, lifetime illicit drug use, and previous substance abuse treatment. In Spain, 20% of respondents who ever have used gabapentinoids, reported a lifetime NMU; the prevalence was higher for pregabalin 624 (6.2%) than for gabapentin 444 (4.4%). The main reasons for use were to self-treat pain and other medical conditions.Conclusions: The risk of NMU of gabapentinoids should not be neglected. Subjects with a history of chronic pain and lifetime substance use disorders had an increased risk of NMU of gabapentinoids.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Non-medical Use of Prescription Gabapentinoids (Gabapentin and Pregabalin) in Five European Countries

et al. 2021

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“…Insgesamt kann Pregabalin noch nicht als Medikation im BZD-Entzug empfohlen werden [105]. Keine große Bedeutung haben Betablocker [106] oder Valporat [107], auch wenn dies gelegentlich empfohlen wird [108]. Experimentell wurde eine "rapid detoxification" von Benzodiazepinen mit Flumazenil, einem BZD-Antagonisten [109,110] empfohlen.…”

Section: Dsm -5-symptomeunclassified

“…Wichtig sind Setting-Effekte: Anders als bei anderen Süchten werden die meisten Patienten nicht im eigentlichen Suchthilfesystem, sondern eher beim Hausarzt, Psychiater oder in der Psychosomatik behandelt [1][2][3]. Die Anzahl kontrollierter Studien in diesem Bereich ist überschaubar [107,120,121]. Generell wirkt Psychotherapie bei Patienten mit BZD-Abhängigkeit und -entzug besser als "treatment as usual" [122,123].…”

Section: Psychosoziale Therapien Und Psychoedukationunclassified

Missbrauch und Abhängigkeit von Benzodiazepinen und Z-Drugs

Soyka¹

2021

Nervenheilkunde

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ZUSAMMENFASSUNGMissbrauch und Abhängigkeit von Sedativa und Hypnotika sind klinisch häufig (Prävalenz ca. 2%), insbesondere von Benzodiazepinen und Non-Benzodiazepin-Hypnotika (Z-Drugs). Beide Substanzgruppen haben ältere und weit toxischere Sedativa und Hypnotika wie Barbiturate und Meprobamat zu Recht verdrängt. Benzodiazepine wie Z-Drugs entfalten ihre Wirkung über den inhibitorischen GABA-Rezeptor und können beide eine erhebliche Toleranz induzieren, was klinisch zu Dosissteigerungen, physischer und psychischer Abhängigkeit, Kontrollverlust sowie Entzugssymptomen führen kann. Prädisponierende Faktoren sind neben dem Geschlecht, Frauen sind häufiger betroffen, vor allem psychiatrische und psychosomatische Erkrankungen, insbesondere Angst und Schlafstörungen, aber auch psychosomatische Störungen und chronische Schmerzerkrankungen. Besonders häufig und lange werden Benzodiazepine älteren Patienten verschrieben, entgegen aller Leitlinienempfehlungen.Therapeutisch gesichert ist, dass bei Benzodiazepinabhängig-keit ein langsames Ausschleichen über viele Wochen, manchmal sogar Monate notwendig ist. Ansonsten können erhebliche Entzugserscheinungen inklusive epileptischen Anfällen, Psychosen und Delire auftreten. Das Entzugssyndrom bei Sedativa und Hypnotika ist sehr vielgestaltig mit Depression, Agitation, innerer Unruhe und Perzeptions-und Schlafstörungen als häufigen Symptomen. Die übrige Therapie ist pragmatisch und richtet sich nach den zugrunde liegenden psychischen Störungen und Entzugssymptomen. Im Wesentlichen werden Antidepressiva eingesetzt. Kurzzeitinterventionen werden empfohlen. Psychotherapeutisch haben sich Psychoedukation, kognitive Verhaltenstherapie oder motivationale Therapien bewährt.

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“…Research on non-benzodiazepine GABAergic medications, such as pregabalin [ 34 , 35 , 36 ] or gabapentin [ 37 ], has been conducted for BDZ tapering and withdrawal management, with conflicting results. Other adjuvant medications were studied as augmentation strategies during BDZ tapering in order to facilitate the outcome and reduce the negative symptoms [ 38 , 39 ].…”

Section: Introductionmentioning

confidence: 99%

Add-On Treatment with Passiflora incarnata L., herba, during Benzodiazepine Tapering in Patients with Depression and Anxiety: A Real-World Study

et al. 2023

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Chronic and inappropriate benzodiazepine intake represents an important health and social concern worldwide. The aim of our study was to investigate the effectiveness of P. incarnata L., herba, in reducing benzodiazepine misuse in a real-world population of depressed and anxious patients in a long-term treatment with benzodiazepines. We conducted a retrospective naturalistic study on 186 patients undergoing benzodiazepine downtitration, 93 with the addition of a dry extract of P. incarnata L., herba (Group A), and 93 without any add-on treatment (Group B). Regarding the benzodiazepine dosage variation in the two groups, a repeated measure ANOVA showed a significant effect of time (p < 0.001), group (p = 0.018), and time x group interaction (p = 0.011). We found a significantly higher rate, i.e., of 50%, reduction in Group A vs. Group B at 1 month (p < 0.001) and at 3 months (p < 0.001) and complete benzodiazepine discontinuation at 1 month (p = 0.002) and at 3 months (p = 0.016). Our findings suggest the role of P. incarnata as an effective add-on treatment during benzodiazepine tapering. These findings highlight the need for further studies to better investigate the promising properties of P. incarnata in the management of such a relevant clinical and social issue.

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Pregabalin as adjunctive therapy in benzodiazepine discontinuation

Cited by 10 publications

References 15 publications

Non-medical Use of Prescription Gabapentinoids (Gabapentin and Pregabalin) in Five European Countries

Non-medical Use of Prescription Gabapentinoids (Gabapentin and Pregabalin) in Five European Countries

Missbrauch und Abhängigkeit von Benzodiazepinen und Z-Drugs

Add-On Treatment with Passiflora incarnata L., herba, during Benzodiazepine Tapering in Patients with Depression and Anxiety: A Real-World Study

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