HWN Suggests

Gabapentinoids for Pain: Potential Unintended Consequences

Gabapentinoid drugs—specifically gabapentin (Neurontin) and pregabalin (Lyrica)—are increasingly being prescribed for pain because physicians and patients seek alternatives to opioids in the midst of the opioid crisis. However, such widespread and often indiscriminate prescribing of gabapentinoids is not supported by robust evidence, and it carries known and unknown risks... The transition of gabapentinoids into a first-line pain medication is in part due to an intentional marketing strategy by the pharmaceutical industry (now well documented in the medical literature) that involved widely promoting off-label use with low-quality, industry-funded studies manipulated to exaggerate the perceived…

read full article

Featured

 Gabapentinoids: repeating mistakes of the past?

Gabapentin and pregabalin misuse occurs commonly in combination with other sedating psychotrophics such as opioids or benzodiazepines, increasing the risk of harms. Opioid use disorder is the greatest risk factor for misuse [2]. Other at-risk populations include people living with substance use disorder, chronic pain or mental health conditions and those in prison.

Articles of Interest

Gabapentinoids: a therapeutic review

Clinicians should be aware of the limited approved indications for gabapentinoids. Caution is required when prescribing these drugs off label because there are significant risks of serious adverse events (including death), development of dependence and withdrawal symptoms on abrupt cessation.

Gabapentinoids: The rise of a new misuse epidemics?

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, in the context of the “opioid epidemics”, gabapentinoids, which had a reputation for low risk of abuse, have been increasingly prescribed. This was accompanied by increasingly frequent abuses, the patients most at risk being those suffering from opiate addiction. However, gabapentinoids increase the risks associated with opioids or other sedatives, due to a synergy of central depressant effects. This leads to reconsider the framework of their prescription and the management of chronic pain.