Über das Abhängigkeitspotential von Gabapentinoiden

Bonnet, Udo; Scherbaum, Norbert

doi:10.1055/s-0043-122392

Cited by 12 publications

(3 citation statements)

References 146 publications

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“…It should be strongly indicated in these patients. Most importantly, physicians should be very cautious about prescribing pregabalin to patients with a history of substance-related disorders ( 20 , 21 ). Less than half of the physicians surveyed prescribe pregabalin for the approved indications of neuropathic pain, generalized anxiety disorder and epilepsy.…”

Section: Discussionmentioning

confidence: 99%

Pregabalin use in forensic hospitals and prisons in German speaking countries—a survey study of physicians

Novotny,

Bulla,

Hubl

et al. 2024

Front. Public Health

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BackgroundPregabalin is a gamma-aminobutyric acid (GABA) analog that was approved in the EU in 2004 for the treatment of neuropathic pain, generalized anxiety disorder and epilepsy. Since its introduction, pregabalin abuse and misuse has increased significantly. In Switzerland, clinical reports suggest that pregabalin misuse is common among patients in forensic hospitals and prisons. However, data on pregabalin use is scarce, especially in these settings. Therefore, we conducted a study to explore patterns of pregabalin use among prison and forensic patients.MethodsWe used a questionnaire to survey physicians working in prison and forensic medicine in German-speaking countries. A total of 131 responses were received.ResultsAccording to the physicians' subjective assessment, 82.5% of them had observed a recent increase in pregabalin use by their patients and 89.1% of them reported that their patients requested pregabalin without a clear medical indication. Patients misusing pregabalin in combination with other illicit substances were observed by 93.3% of the physicians surveyed. According to 73.5% of the physicians surveyed, they had already encountered patients on pregabalin doses of more than 600 mg/day (the maximum recommended daily dose); the highest dose reported was 4,200 mg/day. According to 85.0% of physicians surveyed, they have observed patients experiencing withdrawal symptoms from pregabalin, with the most commonly reported symptoms being displeasure and high aggression. Regarding the nationality of pregabalin-misusing patients, 58.3% of the interviewed physicians reported to be rather in contact with foreign patients, mainly from Northwest Africa (Maghreb). Only 45.0% of the surveyed physicians prescribe pregabalin. Among patients who developed behavioral problems while taking pregabalin, none of the physicians (0.0%) showed a tendency to continue pregabalin at the same dose; all respondents chose to reduce/substitute/discontinue.ConclusionOur study has provided confirmatory evidence that the use of pregabalin presents a significant issue in forensic and prison medicine across German-speaking countries. Prescribing pregabalin in this field can compound use disorder problems and exacerbate challenges in daily life for those in forensic institutions or prisons. It is necessary that all physicians who prescribe pregabalin are clearly informed about the management (including the risks) of this drug.

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Section: Discussionmentioning

confidence: 99%

Pregabalin use in forensic hospitals and prisons in German speaking countries—a survey study of physicians

Novotny,

Bulla,

Hubl

et al. 2024

Front. Public Health

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“…While most patients with chronic pain can be managed conservatively with medication or therapy, it does not always prove to be straightforward. Patients may have to deal with central nervous system side effects or dependence and still not achieve sufficient pain relief [31].…”

Section: Discussionmentioning

confidence: 99%

Is pain control for chronic neuropathic pain after inguinal hernia repair using endoscopic retroperitoneal neurectomy effective? A meta-analysis of 142 patients from 1995 to 2022

Taha‐Mehlitz¹,

Taha

Janzen³

et al. 2023

Langenbecks Arch Surg

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Purpose Neuropathic pain is a complication after groin hernia surgery. Triple neurectomy of the iliohypogastric nerve, ilioinguinal nerve and genitofemoral nerve is an efficient treatment modality, with several surgical approaches. The minimally invasive endoscopic method to neurectomy was specifically investigated in this meta-analysis. Our aim is to determine the efficacy of this method in the treatment of chronic neuropathic pain posthernia repair surgery. Methods A systematic review was conducted using four databases to search for the keywords (“endoscopic retroperitoneal neurectomy” and “laparoscopic retroperitoneal neurectomy”). The NCBI National Library of Medicine, Cochrane Library, MEDLINE Complete and BioMed Central were last searched on 26 May 2022. Randomised control trials and retrospective or prospective papers involving endoscopic retroperitoneal neurectomy operations after inguinal hernia repair were included. All other surgeries, procedures and study designs were excluded. The internal quality of included studies was assessed using the Newcastle–Ottawa Scale. The percentage of patients who had reduction in pain (“positive treatment outcome”) was used to assess the procedure’s effectiveness in each analysis. Results Five comparable endoscopic retroperitoneal neurectomy studies with a total of 142 patients were analysed. Both the Wald test (Q (6) = 1.79, = .775) and the probability ratio test (Q (6) = 4.24, = .374) provide similar findings (0.000, 0.0% [0.0%; 78%]). The meta-analysis’ key finding is that the intervention was up to 78% effective (95% confidence interval, 71%; 84%). Conclusion Endoscopic retroperitoneal neurectomy can be an effective treatment option for postoperative neuropathic pain relief following surgical hernia repair. Although there is limited reported experience with this technique, it may provide a clinical benefit to the patient. We recommend further prospective data and long-term follow-up studies be conducted to confirm and expand on these outcomes.

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“…Die Verschreibungshäufigkeit von Pregabalin nahm in den letzten Jahren vor allem in den einkommensstarken Ländern zu. Pregabalin gehörte in den letzten Jahren zu den umsatzstärksten Medikamenten weltweit [1][2][3][4][5][6][7][8][9][10][11][12][13][14].…”

Section: Introductionunclassified

Pregabalinmissbrauch und -Abhängigkeit in verschiedenen europäischen Ländern im Hinblick auf deren Substitutionspolitik

Kuhn

Müller

Mutschler

2021

Fortschr Neurol Psychiatr

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Zusammenfassung Einleitung, Fragestellung Pregabalin wurde erstmalig im Jahr 2004 für die Behandlung von peripheren neuropathischen Schmerzen und fokalen epileptischen Anfällen, mit oder ohne sekundäre Generalisierung, zugelassen. Die Verschreibungshäufigkeit nahm seit der Zulassung stark zu. In den Anfängen wurde die Problematik des Missbrauchs und der Abhängigkeitsgefährdung von Pregabalin nur wenig Beachtung geschenkt, erst in den letzten Jahren nahm der Umfang an Veröffentlichungen zu dieser Problematik deutlich zu. Diese Übersichtsarbeit befasst sich mit diesen Risikofaktoren und Risikogruppen des Pregabalinmissbrauchs und der Pregabalinabhängigkeit in unterschiedlichen europäischen Ländern sowie deren Drogenpolitik. Resultate Der Missbrauch und die Abhängigkeit von Pregabalin haben seit der Markteinführung stark zugenommen. Es zeigte sich, dass ein solitärer Missbrauch von Pregabalin selten ist. Meist wird Pregabalin mit anderen Substanzen kombiniert, was auch ein Prädiktor für den Missbrauch von Pregabalin ist. Die Gründe für die nicht verschriebene Einnahme von Pregabalin sind unterschiedlich; es wird einerseits zur Steigerung der psychotropen Wirkung, andererseits zur Linderung der Entzugssymptome eingesetzt. Der Beikonsum von Pregabalin ist nicht ungefährlich, er führt zu tödlichen Überdosierungen oder einem Anstieg der Gesamtmortalität bei zusätzlicher Gabe von Pregabalin zu Methadon. Des Weiteren konnte in Schweden bei 28% der tödlichen Intoxikationen von Drogenabhängigen Pregabalin nachgewiesen werden. Es sind vor allem junge Personen betroffen. In Ländern mit restriktiven Substitutionsprogrammen konnte der Missbrauch von Pregabalin nachgewiesen werden, während in Ländern mit liberaler Drogenpolitik kein Missbrauch festgestellt werden konnte. Die Datenlage in der Schweiz mit einem liberalen Substitutionsprogramm beruht jedoch nur auf einer einzigen Studie, weshalb der Pregabalinkonsum in liberalen Substitutionsprogrammen nicht abschließend geklärt werden kann. Schlussfolgerungen Es scheint einen Zusammenhang zwischen der Drogenpolitik des Landes und der illegalen Einnahme von Pregabalin bei Personen in einem Substitutionsprogramm zu geben. Des Weiteren gibt es Risikofaktoren und Risikogruppen für die Abhängigkeit und den Missbrauch von Pregabalin.

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Über das Abhängigkeitspotential von Gabapentinoiden

Cited by 12 publications

References 146 publications

Pregabalin use in forensic hospitals and prisons in German speaking countries—a survey study of physicians

Pregabalin use in forensic hospitals and prisons in German speaking countries—a survey study of physicians

Is pain control for chronic neuropathic pain after inguinal hernia repair using endoscopic retroperitoneal neurectomy effective? A meta-analysis of 142 patients from 1995 to 2022

Pregabalinmissbrauch und -Abhängigkeit in verschiedenen europäischen Ländern im Hinblick auf deren Substitutionspolitik

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