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NEJM: Increased RX of Gabapentin/Pregabalin Cause for Concern?

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drusso

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"Third, evidence suggests that some patients misuse, abuse, or divert gabapentin and pregabalin.5Some users describe euphoric effects, and patients can experience withdrawal when high doses are stopped abruptly. The likelihood of gabapentinoid abuse is reportedly heightened among current or past users of opioids and benzodiazepines. Whether misuse and abuse of gabapentinoids will become an important public health issue remains to be seen."
 

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Lecithin5

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"Third, evidence suggests that some patients misuse, abuse, or divert gabapentin and pregabalin.5Some users describe euphoric effects, and patients can experience withdrawal when high doses are stopped abruptly. The likelihood of gabapentinoid abuse is reportedly heightened among current or past users of opioids and benzodiazepines. Whether misuse and abuse of gabapentinoids will become an important public health issue remains to be seen."

Geez, they keep taking away what little we have in our already depleted toolbox!
 

lobelsteve

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Hmm.

Must be the drug?

It is the person and not the drug.

"Third, evidence suggests that some patients misuse, abuse, or divert gabapentin and pregabalin.5Some users describe euphoric effects, and patients can experience withdrawal when high doses are stopped abruptly. The likelihood of gabapentinoid abuse is reportedly heightened among current or past users of opioids and benzodiazepines. Whether misuse and abuse of gabapentinoids will become an important public health issue remains to be seen."
No.
 

willabeast

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There can be only one possible explanation for this NEJM article - the drug companies are about to release a new non generic gabapentin/pregabalin replacement. They have to trash the cheap generic that does the same thing first, otherwise there would be no reason to pay 10X more for the new drug. When you have been around for a long time you see this over and over. Prediction - if anyone does a RCS and compares the new drug with the old drug's tendency towards addiction, there will be no difference. Another prediction - no one will fund that study.
 
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SeniorWrangler

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I have personally seen people abuse and seek out prescriptions for dilantin and benadryl.
I do regard requests for pregabalin > 600mg/day with suspicion, however...
 

melancholy

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have seen patients with addiction keep "losing" their gabapentin multiple times a month. had to put a stop to that.
 
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DrCommonSense

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There can be only one possible explanation for this NEJM article - the drug companies are about to release a new non generic gabapentin/pregabalin replacement. They have to trash the cheap generic that does the same thing first, otherwise there would be no reason to pay 10X more for the new drug. When you have been around for a long time you see this over and over. Prediction - if anyone does a RCS and compares the new drug with the old drug's tendency towards addiction, there will be no difference. Another prediction - no one will fund that study.

NEJM is a ***** for the big pharma boys that haven't been innovative for years.

You are 100% on point here.
 
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PinchandBurn

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NEJM is a ***** for the big pharma boys that haven't been innovative for years.

You are 100% on point here.
I prescribe both gabapentin and lyrica frequently. Never had a patient loose a RX or call in early for it. No one has ever said its euphoric. Usually sedation or weight gain are the side effects. I was always curious why lyrica is a "controlled" substance, no one in my practice has ever wanted to abuse it....
 
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Blitz2006

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Yeah from an addiction psych standpoint, addiction psychiatrists like to prescribe neurontin/lyrica for anxiety, even EtOH withdrawal sometimes on a detox/rehab unit. While patients can abuse it (patients can abuse any drug theoretically), the impact is relatively safe compared to abusing opioids...
 

epidural man

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I'm not sure why anyone would care if their patient was abusing Lyrica.

I can't see someone stealing and breaking into houses to get money for LYrica.

I can't see anyone giving free blow jobs, or having the wife and kids leave them because they are strung out on Lyrica.

I can't see someone passed out on the street with the LYrica bottle still in the hand.
 
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drusso

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I'm not sure why anyone would care if their patient was abusing Lyrica.

I can't see someone stealing and breaking into houses to get money for LYrica.

I can't see anyone giving free blow jobs, or having the wife and kids leave them because they are strung out on Lyrica.

I can't see someone passed out on the street with the LYrica bottle still in the hand.

Maybe the Lyrica causing euphoria.
 
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