Pharmacovigilance bodies in various European countries have received disturbing reports of adverse effects associated with gabapentin and pregabalin, drugs prescribed to treat partial epilepsy, neuropathic pain and general anxiety. These substances put patients at risk of dependence and abuse, including those who have no history of drug addiction.

Patients who have massively increased the dosage of these drugs claim they wanted to relieve their pain. Dependent patients gain access to high doses of these substances by exaggerating their pain or obtaining prescriptions from several doctors dispensed from different community pharmacies.

It seems difficult for patients to stop taking these drugs as they sometimes experience withdrawal syndrome. In some cases, hospitalisation was necessary.

Abuse of these drugs is also found in drug users seeking the "euphoric" effect similar to that of amphetamines.

Prescrire urges doctors to weigh up the expected benefits of these drugs carefully for each patient, and to avoid exposure in situations where the evidence of benefits is scarce, such as generalised anxiety. And also to inform patients of the risks, be on the alert for exaggerated requests by patients and, if necessary, help them withdraw.

©Prescrire 1 June 2012

"Gabapentin and pregabalin: abuse and addiction" Prescrire Int 2012; 21 (128): 152-154 (Pdf, subscribers only).