Current Evidence on Abuse and Misuse of Gabapentinoids

• Published in: Drug safety 2020-12, Vol.43 (12), p.1235-1254
• Main Authors: Hägg, Staffan, Jönsson, Anna K., Ahlner, Johan
• Format: Article
• Language: English
• Subjects: Addictions; Disorders; Drug abuse; Drug dosages; Drug Safety and Pharmacovigilance; Drug use; Fibromyalgia; Forensic science; Forensic toxicology; Gabapentin; Generalized anxiety disorder; Medical personnel; Medicine; Medicine & Public Health; Mental disorders; Opioids; Pain; Pharmacology/Toxicology; Pharmacovigilance; Review; Review Article; Risk analysis; Risk factors; Substance use; Toxicology
• ISSN: 0114-5916; 1179-1942; 1179-1942
• DOI: 10.1007/s40264-020-00985-6

This review summarizes current evidence on the abuse and misuse of the gabapentinoids pregabalin and gabapentin. Pharmacovigilance studies, register-based studies, surveys, clinical toxicology studies, and forensic toxicology studies were identified and scrutinized with the goal to define the problem, identify risk factors, and discuss possible methods to reduce the potential for abuse and misuse. Studies found that gabapentinoids are abused and misused and that individuals with a history of psychiatric disorders or substance use disorder seem to be at high risk. Moreover, some evidence supports the notion that patients with opioid use disorders may be at an increased risk of abusing gabapentinoids. Available evidence also suggests that abuse and misuse are more frequent in users of pregabalin compared with users of gabapentin. Health professionals and prescribers should be aware of the risk for misuse of pregabalin and gabapentin, which eventually could lead to abuse, substance dependence, and intoxications. Prescribing to patients belonging to risk populations such as those with psychiatric disorders or substance use disorder should be avoided if possible and, if prescribed, signs of misuse and abuse should be monitored.