Determining the Toxicological Significance of Pregabalin in Fatalities

Pregabalin has become more widely prescribed and abused in recent years but is still not always included in laboratory analysis. An LC‐MS‐MS method has been developed and applied to measure pregabalin in 93 postmortem cases, including drug‐related deaths, alternative causes of death, and fatalities...

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Bibliographic Details
Published in:Journal of forensic sciences 2017-01, Vol.62 (1), p.169-173
Main Authors: Elliott, Simon P., Burke, Timothy, Smith, Christopher
Format: Article
Language:English
Subjects:
Alcohol
Anti-Anxiety Agents - blood
casework
Chromatography, Liquid
Fatalities
Forensic pathology
forensic science
Forensic Toxicology
Humans
liquid chromatography–mass spectrometry
Mass Spectrometry
Narcotics - blood
Pharmaceutical Preparations - blood
poly‐drug use
postmortem
pregabalin
Pregabalin - blood
Substance-Related Disorders - blood
Toxicology
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Summary:Pregabalin has become more widely prescribed and abused in recent years but is still not always included in laboratory analysis. An LC‐MS‐MS method has been developed and applied to measure pregabalin in 93 postmortem cases, including drug‐related deaths, alternative causes of death, and fatalities where pregabalin was likely to have contributed to death. Other drugs or alcohol was detected, and the most common drug types (in decreasing frequency) were antidepressants, opioids, benzodiazepines, opiates, alcohol, antipsychotics, cocaine, cardiac drugs, amphetamines, cannabis, anticonvulsants, and antihistamines. New psychoactive substances (methoxphenidine and synthetic cannabinoids) were only found in two cases. The results provide further data to assist in evaluating the significance of postmortem pregabalin concentrations and a toxicologically significant concentration of 25 mg/L is proposed. Pregabalin, especially with concomitant use of other CNS depressant drugs, presents a significant toxicological risk and existing laboratory protocols should be reviewed for their suitability to detect pregabalin.
ISSN:0022-1198
1556-4029
DOI:10.1111/1556-4029.13263