Author: Gary Jackson

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

Drug-related deaths involving pregabalin have risen over the years, according to the Northern Ireland Statistics and Research Agency (Nisra). “It is a very dangerous drug when used in the wrong doses, by the wrong person, or when it is mixed with other medication in a way that we cannot really predict what the outcome will be.” Pregabalin can be safe when prescribed and taken under medical supervision, but very dangerous when taken recreationally, Londonderry GP Joe McEvoy has said.

Case reports and reviews were excluded as well as animal and in vitro studies. In total, 432 different articles were initially identified and read, 391 articles were removed and not included in the analysis. Hence, the remaining 41 articles were included and are presented in the tables.

Abuse Potential of Pregabalin: A Systematic Review

In America, Lyrica is considered a relatively safe drug with a low potential for abuse. However, other countries are realizing the dangers of Lyrica addition and abuse. Weight gain can also occur if you’re taking certain diabetes medications called thiazolidinediones. Combining Lyrica with thiazolidinediones can cause swelling, which can increase your weight.

  • Regarding fatalities after overdoses of gabapentinoids, there a number of retrospective studies from regional or national post-mortem toxicology registers in Finland [56–58] Sweden [30], Germany [102], and the UK [54].
  • Articles were considered relevant if related to gabapentinoid abuse, misuse, dependence, addiction, and overdoses in humans.
  • Gabapentinoids are widely used in conditions where they are not approved and in higher doses than recommended.
  • Given the frequent abuse and misuse of gabapentinoids, standard urine drug screening should include these substances [68].
  • According to Pharma Marketing (2018), PGB reached the tenth position in terms of gross sales in 2017 (~5.1 billion USD) and its annual sales growth rate was ~2.8% (7).

Opioid-dependent patients admitted misuse in 50% of cases of those prescribed pregabalin and in 40% of those prescribed gabapentin. Patients not prescribed a gabapentinoid admitted misuse of pregabalin in 6% of cases and gabapentin in 13% of cases. However, gabapentinoids are also readily available from drug dealers or the Internet [21, 49, 73].

Utility of Hair Analysis in Clinical Pregabalin Abuse Monitoring

A longitudinal analysis of 3-cm hair samples provided a retrospective timeline of MTT patient contact with various substances. These patients were being administered methadone at doses ranging from a minimum of 15 mg d−1 to a maximum of 120 mg d−1. Other medications such as antidepressants, anti-Parkinson drugs, cough and cold medicines, and stimulants such as methylphenidate are also misused (2, 4, 5).

  • Using this method for ranking the safety of 70 pharmaceuticals, pregabalin and gabapentin were ranked in the middle.
  • The aims of this study were to assess the extent of PGB misuse in the at-risk MTT population and to determine whether PGB is combined with one or more of the traditional drugs tested here.
  • Patients with various diagnoses such as fibromyalgia, painful neuropathies, post-herpetic neuralgia, and generalized anxiety disorder, but also healthy volunteers were included in these studies.
  • However, other differences in regulations, healthcare systems, ease of access, and perceptions by users might also add to these differences.
  • There are studies reporting that 15–22% and 3–68% of patients with opioid use disorders abuse gabapentin and pregabalin, respectively [39–42, 48, 49, 64].

This side effect was reported in studies of Lyrica, but it wasn’t common. Some people experienced impotence (not being able to get an erection). Some people also experienced changes in sex drive, including an increased or decreased libido. The pharmacokinetic profile of PGB limits its potential for interaction with opioids.

Pregabalin: What is it and why can it be dangerous?

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. You can also sign up for Healthline’s type 2 diabetes newsletter or fibromyalgia newsletter if you’re interested in news and advice for either of these conditions. Keeping notes and sharing them with your doctor will help them learn more about how Lyrica affects you.

Our patient had a history of drug addiction, which may be important in the reward effect of pregabalin. We therefore recommend being especially cautious when using pregabalin to treat patients with a history of drug or alcohol dependence. To limit the non-medical off-label use of gabapentinoids, restrictions in prescription and use have been implemented. For example, pregabalin and gabapentin have been classified as a scheduled class C drug in the UK in 2019 [110], meaning that the prescriptions do not allow multiple dispensions and prescriptions are valid for just 1 month. The medical profession supported this change despite an extra burden for prescribers, pharmacists, and patients [111]. A possible mechanism behind the fact that gabapentinoids often are combined with opioids has been suggested by Vashchinkina et al. [90].