Pregabalin versus naltrexone in alcohol dependence: a randomised, double-blind, comparison trial

Martinotti, Giovanni; Nicola, Marco Di; Tedeschi, D.; Andreoli, S.; Reina, Daniela; Pomponi, Maria Grazia; Mazza, Marianna; Romanelli, Roberto Giulio; Moroni, N.; Filippis, Rocco de; Giannantonio, Massimo Di; Pozzi, Gino; Bria, Pietro; Janiri, Luigi

doi:10.1177/0269881109102623

Cited by 60 publications

(33 citation statements)

References 46 publications

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“…In fact, in contrast with abuse liability data, pregabalin may potentially represent a valuable asset in the pharmacological repertoire of addiction medicine [17,37]. Because gabapentinoids are commonly prescribed medications, health professionals should be well aware of both the potential risks for their misuse and the associated discontinuation symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…Pregabalin, at therapeutic daily levels, may present with beneficial effects for both alcohol withdrawal symptoms [36] and alcohol relapse prevention, with data on the maintenance of abstinence being similar to those associated with naltrexone prescription [37,38]. Additionally, pregabalin has been shown to be effective in the withdrawal phase of both benzodiazepine [39] and opiate [40] detoxification, with valuable effects on cue-and stress-induced cocaine relapse [19].…”

Section: Gabapentinoids As a Treatment For Addiction?mentioning

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: Discussionmentioning

confidence: 99%

Section: Gabapentinoids As a Treatment For Addiction?mentioning

confidence: 99%

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

2014

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“…Recently, two small clinical trials provided some demonstration of the efficacy of pregabalin in reducing alcohol withdrawal severity and facilitating abstinence Martinotti et al 2010). In the light of these preliminary clinical findings and based on the results of the present study, it is possible to hypothesize that pregabalin may represent a new useful approach for the treatment of alcoholism.…”

Section: Discussionmentioning

confidence: 99%

Pregabalin reduces alcohol drinking and relapse to alcohol seeking in the rat

Stopponi

Somaini²,

Cippitelli

et al. 2011

Psychopharmacology

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“…The efficacy of anticonvulsants in preventing epileptic seizures during alcohol withdrawal is, in fact, well established; furthermore, they are considered to interact with the reward system. 8 Moreover, the efficacy of some anticonvulsants in treating psychiatric symptoms in substance use disorder patients [10][11][12] is also relevant, given the high number of alcohol-dependent subjects presenting a dual diagnosis. 13 Topiramate, a sulfamate-substituted analogous of fructose-1,6-diphosphate, is a potent antiepileptic 14 with strong neuroprotective properties.…”

mentioning

confidence: 99%