Misuse of popular anti-epileptic drug linked to number of deaths

Pregabalin is one of Australia’s most-prescribed drugs, with its use skyrocketing since being listed on the Pharmaceutical Benefits Scheme (PBS) in 2013.
 
But with its popularity has come rising misuse of the anti-epileptic drug, sold under the name Lyrica, which has contributed to hundreds of deaths.
 
According to a new report in The Age, ‘an explosion of overdoses and deaths has led to growing concern about the misuse and safety’ of pregabalin.
 
‘Between 2013 and 2017, [pregabalin] contributed to 164 overdose deaths in Victoria, with the number increasing almost every year, according to coronial data. Between 2009 and 2012, that number was zero,’ reporters in The Age wrote.
 
‘In NSW, there were 88 pregabalin-associated deaths between 2005 and 2016, according to a study of that state’s coronial data, with similar significant increases since 2013.’
 
Pregabalin is often prescribed as a painkiller for nerve pain.
 
While traditionally considered to be non-addictive and have a low potential for abuse, there is growing evidence of the drug’s misuse.

According to a new study published in the Medical Journal of Australia (MJA), the rate of pregabalin-related ambulance attendances has increased tenfold since 2012. It was found that patients have frequently misused pregabalin with other sedatives, particularly benzodiazepines, and suicide attempts accounted for almost 40% of misuse-related events that required paramedic attendance.
 
‘We found … that a large of proportion of people who misuse pregabalin and require paramedic assistance concurrently use other sedatives, and that pregabalin misuse is associated with acute psychiatric and medical harms,’ researchers wrote.
 
Writing in The Conversation, the MJA researchers stated the first study on the misuse of pregabalin was published in 2010.
 
‘Since then, several international research articles have documented misuse, including using higher doses than are recommended. At higher-than-prescribed doses, pregabalin causes sedation and euphoria,’ they wrote.
 
‘People who use opioids – painkillers like oxycodone, or illicit opioids such as heroin – have a particularly high risk of misusing pregabalin. So do those with a history of substance use problems.
 
‘People who use illicit drugs report often using pregabalin in combination with other drugs. Pregabalin has been implicated in drug-related deaths in individuals who weren’t prescribed the medication, and often in combination with other sedative medications or illicit drugs.’
 
Researchers have recommended prescribers ‘ensure patients are provided with the opportunity for careful and considered informed consent’.
 
‘Pregabalin is a high-risk medication, especially when used with other sedatives. Although some doctors are aware of the side effects and harms associated with pregabalin, many are not,’ they wrote.

ambulance attendances Lyrica Medical Journal of Australia overdose Pregabalin