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Gabapentin was found at very high frequency in accidental mixed drug fatalities. Gabapentin concentrations were generally within the normal therapeutic range (2-20 μg/mL). It is unknown whether a synergistic effect with opioids may contribute to central respiratory depression. Neurontin (gabapentin) is a medication that is used for several different conditions such as nerve pain, epilepsy, and many others. While overdoses with gabapentin are rare, it is important to know the symptoms of an overdose and the risk factors that increase the likelihood of an overdose. To avoid an overdose, take gabapentin as directed. Only 19 deaths involving gabapentin were identified as possible suicides during the five-year study period, but there were thousands of gabapentin-related calls each year coded as attempted suicides — including over 10,000 calls in 2017 alone. Of the 58,362 overdose deaths with toxicology results in 2019 and 2020, 5,687 (9.7%) showed positive results for gabapentin. Gabapentin was believed to be a factor in 2,975 of these 5,687 deaths (52.3%). An overwhelming majority of these deaths — around 90% — also involved opioids like fentanyl. When Gabapentin is either mixed with opioids or alcohol, it can cause individuals misusing the drugs to overdose, and even risk death from the Gabapentin itself. Opioid overdose can often be reversed by administering naloxone, which many states have made available to purchase over the counter. Emergency services must still be contacted immediately. Gabapentin is an antiepileptic drug that is prescribed for both FDA-approved and multiple off-label conditions, and has a relatively safe side-effect profile. Rare cases of overdose-related adverse effects have been reported in the literature. Described herein are the circumstances and autopsy findi A gabapentin overdose is rare, but it is possible. The likelihood of an overdose increases when you abuse gabapentin with other drugs like opioids and alcohol. If you or someone you know is experiencing a gabapentin overdose, seek medical help immediately. Gabapentin, primarily used for treating seizures and neuropathic pain, has been increasingly detected in postmortem toxicology tests, with a rise in overdose deaths noted between 2019 and 2020. While overdose is often associated with misuse or intentional self-harm, accidental ingestion remains a critical concern. Postmortem toxicology tests detected gabapentin in almost 1 in 10 US overdose deaths between 2019 and 2020. In about half of the cases, a medical examiner or coroner ruled the drug was a cause of the death, according to a report from the CDC’s Division of Overdose Prevention. Most gabapentin-involved overdose deaths, 83.2%, occurred among non-Hispanic White persons. More than half of gabapentin-involved deaths, 52.2%, occurred among persons aged 35 to 54 years. Gabapentin-involved overdose deaths occurred with nearly equal frequency among men and women. Gabapentin Increasingly Implicated in Overdose Deaths The first death with gabapentin detected occurred in 2004, and with pregabalin in 2006. The number of deaths following gabapentinoid use has increased (Figure 1A): 8.9% of all NPSAD reports in 2014 detected a gabapentinoid, rising to 32.3% in 2020. In our series, we review 104 cases of decedents who tested positive for gabapentin in postmortem blood samples and an additional 53 nonfatal cases of motor vehicle drivers suspected of driving under the influence. In 47.1% of the fatality cases, gabapentin was directly involved in death. Data on 62,652 overdose deaths that occurred during 2019 – 2020 in the 24 jurisdictions were entered in SUDORS; among 58,362 deaths with documented toxicology results, a total of 5,687 (9.7%) had gabapentin detected on postmortem toxicology. Most gabapentin-involved overdose deaths, 83.2%, occurred among non-Hispanic White persons. More than half of gabapentin-involved deaths, 52.2%, occurred among persons aged 35 to 54 years. Data on 62,652 overdose deaths that occurred during 2019–2020 in the 24 jurisdictions were entered in SUDORS; among 58,362 deaths with documented toxicology results, a total of 5,687 (9.7%) had gabapentin detected on postmortem toxicology. Individuals who died from a gabapentin-related overdose were most likely to be non-Hispanic white (83%), between the ages of 35 and 54 years (52%), with men and women equally affected. Deaths hit a peak in the second quarter of 2020, but remained high through the rest of the study period. Gabapentin and pregabalin are commonly prescribed medications for the treatment of seizure disorders, neuropathic pain (eg, postherpetic neuralgia), fibromyalgia, anxiety, post-traumatic stress disorder, and restless leg syndrome. Gabapentinoids are commonly ingested in self-harm attempts and often misused for their sedative and euphoric The demographics of these overdose deaths are counter to many trends in opioid-involved overdose deaths. Despite higher opioid-involved overdose death rates overall ( Hedegaard et al., 2022 ), men have typically had lower rates of overdoses deaths involving opioids and gabapentinoids/Z-drugs than women. However, people taking gabapentin should be aware that it does have particularly unpleasant withdrawal symptoms, even after taking it for a relatively short amount of time and at low doses. Symptoms of Gabapentin Overdose. Most side effects of a gabapentin overdose will be related to an overall deceleration of the body’s systems.
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