Management of gabapentin misuse in a patient with previous history of opioid use disorder: Case report

• Published in: Asian journal of psychiatry 2023-02, Vol.80, p.103322-103322, Article 103322
• Main Authors: Jalilian Khave, Laya, Noori, Mehri, Rahimi-Movaghar, Afarin, Noroozi, Alireza
• Format: Article
• Language: English
• Subjects: Adult; Analgesics, Opioid - adverse effects; Buprenorphine - therapeutic use; Case report; Gabapentin; Gabapentin - therapeutic use; Humans; Male; Opioid-Related Disorders - complications; Opioid-Related Disorders - drug therapy; Substance use disorder
• ISSN: 1876-2018; 1876-2026
• DOI: 10.1016/j.ajp.2022.103322

We present a 37-year-old male who misuses 12 g of gabapentin per day associated with dependence and withdrawal. He had a previous history of opioid use disorder (OUD) which has been in remission. An outpatient gradual dose reduction regimen was tried and failed and the patient decided to discontinue gabapentin abruptly. Symptomatic medication to relieve gabapentin withdrawal was also unsuccessful and resulted in the reinstatement of OUD. Finally, the patient was stabilized using buprenorphine maintenance treatment and discontinued opioids and gabapentin misuse. The clinical implications and significance of taking regulatory actions to control gabapentin misuse have been discussed. •We presented a case who treated for gabapentin dependence, with a previous history of opioid use disorder (OUD).•Symptomatic management of gabapentin withdrawal also failed and led to the reinstatement of OUD.•Buprenorphine maintenance treatment helped the patient to cease opioids use and prevented relapse to gabapentin use.•This case shows the need for more intensive treatment for gabapentin withdrawal management in a patient with previous OUD.•The importance of taking regulatory actions for gabapentionoids use by the Iran Ministry of Health has been discussed.