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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. Gabapentin and pregabalin are indicated for the treatment of neuropathic pain only. Use in other types of pain is unapproved. Cases of abuse and dependence have been reported with gabapentin and pregabalin. Evaluate patients for a history of substance abuse and observe for signs of misuse or abuse. 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. As of 1 April 2019, pregabalin and gabapentin are controlled under the Misuse of Drugs Act 1971 as Class C substances and scheduled under the Misuse of Drugs Regulations 2001 as Schedule 3. 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. The gabapentinoid drugs, gabapentin and pregabalin, are first-line treatments for neuropathic pain. The epidemics of chronic pain and opioid misuse have given rise to the widespread use of non-opioid drugs such as the gabapentinoids for treatment. Background: Gabapentinoid (pregabalin and gabapentin) abuse is increasingly being reported. Objective: To assess the extent of gabapentinoid abuse, characteristics of typical abusers, patterns of abuse, and potential harms in order to bring this trend to providers' attention. Pregabalin appeared to be somewhat more addictive than gabapentin regarding the magnitude of behavioral dependence symptoms, transitions from prescription to self-administration, and the durability of the self-administrations. The gabapentinoid group consists of gabapentin and pregabalin. Structurally similar to the inhibitory neurotransmitter GABA (gamma-aminobutyric acid), gabapentinoids bind to a subunit (protein α2-δ) of a voltage-dependent calcium channel in the central nervous system, decreasing the intracellular calcium influx induced by cell depolarization, and the release of exciting neurotransmitters. Prescribers should exercise appropriate caution with use in high-risk populations and monitor for signs of misuse or abuse. Evidence suggests that gabapentinoid misuse/abuse represents a growing trend that is causing significant patient harm. Healthcare professionals should take care to prevent and detect addiction to pregabalin or gabapentin. When necessary, assistance with tapering off the medication should be offered. 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. Gabapentinoid (pregabalin and gabapentin) abuse is increasingly being reported. To assess the extent of gabapentinoid abuse, characteristics of typical abusers, patterns of abuse, and potential harms in order to bring this trend to providers’ attention. Professionals prescribing pregabalin and gabapentin should be aware not only of the potential benefits of these drugs to patients, but also that the drugs can lead to dependence and may be Gabapentin requires a prescription, but generally has no additional controls (66–69); however, pregabalin, its close structural relative, which was approved after gabapentin, was placed into Schedule V (abuse potential) in the US and included in the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)-Europol annual report on new Pregabalin appeared to be somewhat more addictive than gabapentin, taking into consideration that the pregabalin use was more frequently associated with behavioral ICD-10-dependence symptoms, switches from prescription to self-administration and self-administrations themselves (Table 2). Pregabalin, a gamma-aminobutyric acid analog, is a new-generation anticonvulsant that acts by reducing the release of glutamate, noradrenaline, and substance P. Apart from use as concomitant therapy in partial epilepsy, it is used in the treatment of treat neuropathic pain, fibromyalgia, and generalized anxiety disorder. The principal population at risk for addiction of gabapentinoids consists of patients with other current or past substance use disorders (SUD), mostly opioid and multi-drug users, who preferred pregabalin. 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 Healthcare professionals should take care to prevent and detect addiction to pregabalin or gabapentin. When necessary, assistance with tapering off the medication should be offered.
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