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Abuse Potential of Pregabalin

A Systematic Review

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Abstract

Background

Several case reports and epidemiological studies have raised concern about the abuse potential of pregabalin, the use of which has increased substantially over the last decade. Pregabalin is, in some cases, used for recreational purposes and it has incurred attention among drug abusers for causing euphoric and dissociative effects when taken in doses exceeding normal therapeutic dosages or used by alternative routes of administration, such as nasal insufflation or venous injection. The magnitude of the abuse potential and the mechanism behind it are not fully known.

Objective

The aim of this study was to present a systematic review of the data concerning the abuse potential of pregabalin.

Methods

We performed a systematic literature search and reviewed the preclinical, clinical and epidemiological data on the abuse potential of pregabalin.

Results

We included preclinical (n = 17), clinical (n = 19) and epidemiological (n = 13) studies addressing the abuse potential of pregabalin. We also reviewed case reports (n = 9) concerning abuse of pregabalin. The preclinical studies indicated that pregabalin possesses modulatory effects on the GABA and glutamate systems, leaving room for an abuse potential. Further, clinical studies reported euphoria as a frequent side effect in patients treated with pregabalin. The majority of case reports concerning abuse of pregabalin involved patients with a history of substance abuse and, similarly, epidemiological studies found evidence of abuse, especially among opiate abusers.

Conclusions

Overall, the available literature suggests an important clinical abuse potential of pregabalin and prescribers should pay attention to signs of abuse, especially in patients with a history of substance abuse.

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Authors and Affiliations

  1. Department of Psychiatry, Aalborg University Hospital, Aalborg, Denmark

    Ole Schjerning & Jimmi Nielsen

  2. Department of Clinical Medicine, Aalborg University, Aalborg, Denmark

    Ole Schjerning & Jimmi Nielsen

  3. Danish Health and Medicines Authority, Copenhagen, Denmark

    Mary Rosenzweig

  4. Clinical Pharmacology, Department of Public Health, University of Southern Denmark, Odense, Denmark

    Anton Pottegård & Per Damkier

  5. Department of Clinical Chemistry and Pharmacology, Odense University Hospital, Odense, Denmark

    Per Damkier

  6. Centre for Schizophrenia, Brandevej 5, 9220, Aalborg, Denmark

    Ole Schjerning

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Correspondence to Ole Schjerning.

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No sources of funding were used to assist with the preparation for this paper.

Conflict of interest

Ole Schjerning has received speaker honoraria from Lundbeck. Jimmi Nielsen has received research grants from Lundbeck, Pfizer and speakers honoraria from Hemocue, Lundbeck and Bristol Myers Squibb. Anton Pottegård, Mary Rosenzweig and Per Damkier state no conflicts of interest.

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Schjerning, O., Rosenzweig, M., Pottegård, A. et al. Abuse Potential of Pregabalin. CNS Drugs 30, 9–25 (2016). https://doi.org/10.1007/s40263-015-0303-6

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