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Gabapentinoid drugs—specifically gabapentin (Neurontin) and pregabalin (Lyrica)—are increasingly being prescribed for pain because physicians and patients seek alternatives to opioids in the Gabapentinoids (e.g. pregabalin and gabapentin) are widely used in neurology, psychiatry and primary healthcare but are increasingly being reported as possessing a potential for misuse. In fact, increasing levels of both prescriptions and related fatalities, together with an anecdotally growing black market, have been reported from a range of countries. This article reviews the current Introduction: The latest decade, an emerging issue has been the abuse potential of the gabapentinoids pregabalin and gabapentin. The aim of our study was to assess this safety signal combining two different methods of surveillance: search analytics Drug withdrawal syndrome, euphoric mood, auditory hallucinations, delusions, and aggression were often reported in combination with drug abuse for gabapentin or pregabalin, giving insight into the psychoactive effects that may be caused by the misuse of these drugs. Despite their inherent abuse potential, gabapentinoids (gabapentin and pregabalin) may be safer than presumed and offer prescribers an effective opioid-alternative treatment for certain types of neuropathic pain. Of the 11 population-based studies and 23 case reports included here, nearly one-third report gabapentin misuse/abuse for recreational purposes and epidemiological studies from the US and UK estimate abuse rates between 40–65% just among individuals with a gabapentin prescription. Some evidence suggests that patients with opioid use disorders may be at an increased risk of abusing gabapentinoids. Available evidence suggests that abuse and misuse are more frequent in users of pregabalin compared with gabapentin. Current literature suggests abuse of pregabalin and gabapentin is a significant and growing concern necessitating further study to characterize gabapentinoid abuse liability and associated risk factors, as well as vigilance among providers to identify and prevent such practices. Background A 2017 systematic review (SR) identified 59 studies examining gabapentinoid (pregabalin and gabapentin) misuse/abuse. Evidence of gabapentinoid misuse/abuse has since grown substantially. Objective Update previous SR and describe new insights regarding gabapentinoid abuse. Methods A SR of PubMed was conducted to identify studies published from 7/29/2016–8/31/2020. Four searches 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 Evidence suggests gabapentinoids possess potential for abuse, particularly in individuals with a history of opioid abuse, and reports of such abuse are increasingly being documented. Prescribers should be aware of high-risk populations and monitor for signs of abuse. In Europe, in mid-2011, about 30 cases of dependence, abuse or withdrawal symptoms attributed to pregabalin had been reported to Swedish and French pharmacovigilance centres and the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). About 20 cases of gabapentin addiction were publishe Physicians considering prescribing gabapentinoids for neurological/psychiatric disorders should carefully evaluate a possible previous history of drug abuse, whilst being able to promptly identify signs of pregabalin/gabapentin misuse and provide possible assistance in tapering off the medication. Abstract Background: Reports of gabapentinoid (gabapentin and pregabalin) misuse have increased in recent years. Pharmacovigilance data from the Food and Drug Administration Adverse Event Reporting System (FAERS) provides a useful examination of adverse drug event (ADE) reporting for safety signal detection. observe patients on pregabalin and gabapentin for possible signs of abuse and dependence, for example, drug-seeking behaviour, dose escalation, and development of tolerance Practitioners should prescribe pregabalin and gabapentin appropriately to minimise the risks of misuse and dependence, and should be able to identify and manage problems of misuse if they Gabapentin and pregabalin abuse has been seen primarily in patients with a history of substance use disorder (SUD), particularly in those who abuse opioids.10 Effects from gabapentinoid abuse may include euphoria, dissociation, relaxation, sedation, and sometimes psychedelic effects. Gabapentinoids and opioids have in common that they are used in medicine in the treatment of pain, and by addicts in recreational use. In recent years 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. Evidence suggests that gabapentinoid misuse/abuse represents a growing trend that is causing significant patient harm. Prescribers should exercise appropriate caution with use in high-risk populations and monitor for signs of misuse or abuse.
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