The gabapentinoids, pregabalin and gabapentin, are widely used for the treatment of epileptic and pain disorders. Pregabalin is also used for generalized anxiety disorder, diabetic peripheral neuropathy, post-herpetic neuralgia, and fibromyalgia [1]. Another gabapentinoid, mirogabalin, is in clinical development and has recently been introduced in Japan for the treatment of peripheral neuropathic pain [2].
Additional Information for Patients and Caregivers
When available, data from systematic reviews and randomised controlled trials were used. No filters were applied to limit the retrieval by study type, although there was a specific focus on human population data. Personal archives of references have been used as well, and consultation with experts to inform this manuscript has occurred.
Abuse Potential of Pregabalin: A Systematic Review
- Other factors may also affect whether Lyrica is a good treatment option for you.
- Consistent with the previous findings from Andrews, et al., the dose of 30 mg/kg did not change place preference in our study.
- Drugs that cause side effects related to breathing include morphine and lorazepam (Ativan).
- Patients treated for opioid addiction abused pregabalin in 12% of the cases, whereas those treated for non-opioid addiction abused pregabalin in only 2% of the cases.
- Pregabalin is an analogue of the neurotransmitter gamma-aminobutyric acid (GABA) that can bind with strong affinity to the α2δ subunit of pre-synaptic voltage-gated calcium channel receptor to decrease post-synaptic excitatory neurotransmitter release11.
A previous study conducted at UHSA showed a high prevalence of mental health disorders among undocumented migrants, with mental disorders due to psychoactive substances being the second most prevalent [11]. This reality highlights the importance of implementing prevention programs targeted at this population and the need for a multidimensional mental health care approach with diagnostic and treatment resources in detention centers. Furthermore, there is a need to increase multicultural competencies of Portuguese clinicians when working with migrants and ethnic minorities to effectively build healthcare interventions. Components of cultural competence include awareness of other’s background, experiences, stereotypes and preconceived notions, knowledge about the groups one works or interacts with and skills in cultural aspects of assessment and intervention. Gabapentinoids (pregabalin and gabapentin) are a class of drugs that have been widely used-prescribed for neuropathic pain, epilepsy, anxiety, and other psychiatric disorders, while pregabalin showed promise as a treatment for alcohol dependence (1, 2).
What are the serious side effects of Lyrica?
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 cocaine illicit use 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.
Abuse Potential of Pregabalin
Only three epidemiological studies mentioned the effects sought bymisusing gabapentin (42, 43, 50); these findings were not presented as inference from asample, rather examples accumulated from individual reporting. Gabapentinoids are FDA-approved to treat a variety of conditions including partial seizures and nerve pain from spinal cord injury, shingles, and diabetes. Gabapentin was first approved in 1993 and pregabalin was first approved in 2004.
Periodic public announcements about the study were also made at a local substance use treatment center. Recruitment materials invited individuals to participate in a confidential, in-person, one-on-one interview. Interested individuals were invited to call the research office to be screened for eligibility and to make an appointment to complete the interview.
The widest category is the “general search term,” where Google returns analytics from searches in all categories. However, since we were studying a very specific area of interest, we could also restrict our alcohol vs marijuana is one safer than the other results in a more specific category (e.g., “medication”). Google is using search semantics to classify each search query and is expected that the more specific category will provide more accurate results.
Prevalence of gabapentin misuse in the general population wasreported to be 1%, 40–65% among individuals withprescriptions, and between 15–22% within populations ofpeople who abuse opioids. An array of subjective experiences reminiscent ofopioids, benzodiazepines, and psychedelics were reported drug addiction articles over a range ofdoses, including those within clinical recommendations. Gabapentin wasprimarily misused for recreational purposes, self-medication, or intentionalself-harm and was misused alone or in combination with other substances,especially opioids, benzodiazepines, and/or alcohol.
However, depending on the search popularity of some terms, there may not be enough results inside the category context, because Google returns only results that can be considered as big data volumes. In our study, we used only the “prescription drug” category for the extraction of our data. Gabapentin is an analog of GABA (1);however, it does not bind to GABAA or GABAB receptors (orbenzodiazepine, opioid or cannabinoid receptors), but it can increase GABA and candecrease glutamate concentrations (2, 3). If you have a breathing disorder, such as respiratory failure, taking Lyrica could worsen your condition. Also, taking Lyrica with other drugs that can affect your breathing can cause respiratory depression (slow, shallow breathing that can be life threatening in rare cases). Drugs that cause side effects related to breathing include morphine and lorazepam (Ativan).
Most of the gabapentinoids were prescribed by a primary care physician (45.8%) and only few by a psychiatrist (4.8%). However, it was noted that most (96.6%) of the gabapentinoid visits did not have an approved indication for the gabapentinoids among the first three recorded diagnoses. The increase in gabapentinoid medication in the USA in recent years has been confirmed by other studies [92, 93]. The reason for the seemingly higher prevalence of prescription drug misuse/abuse of the gabapentinoids in the USA compared with European countries could at least partly be explained by differences in the prescriber’s perception of the safety of gabapentinoids. In a study from the UK [65], it was found that misused gabapentinoids most often are obtained from healthcare providers (63%).
Gabapentin is relatively inexpensive and, in fact, many individuals canacquire it for free or a drastically reduced price under subsidy plans (64–66). Further, due to its widespread off-label prescribing worldwide(8, 11, 12), it is relatively easy toreceive gabapentin by prescription, as illustrated by physicians and the health caresystem being the primary source of misused gabapentin in the US and UK. Thesefactors have enabled the market to be flooded with gabapentin and it has beenreferred to among the drug using population as “a cheap man’shigh” (personal communication). It is important that prescribers recognizethe current diversion of gabapentin and dispense judiciously. Alternatively, several epidemiological studies did identifysimultaneous combination of gabapentin with other substances for theexplicit purpose of misusing them. In Scotland in 2010, approximately 1% of all drug-relateddeaths were directly attributed to gabapentin (42).