More safety concerns with gabapentioids

Gabapentinoids (including gabapentin and pregabalin) are effective for some cases of neuropathic pain, but are increasingly associated with patient safety issues including misuse, and diversion. There is concern about drug-related deaths (DRDs) connected to gabapentinoids. Researchers in Scotland have examined national and regional prescribing rates (2006–2016) with reference sociodemographic factors, co-prescriptions and mortality, including DRDs. Deaths where gabapentinoids were potentially implicated were identified from national records over this 10 year period, during which gabapentin prescriptions in Scotland increased 4-fold (164 630 to 694 293), and pregabalin 16-fold (27 094 to 435 490). In 2016 ‘recurrent users’ (those who had been dispended three or more prescriptions) had mean age 58.1 yr, were more likely to be female (62.5%), and were more likely to live in deprived areas. 60% were co-prescribed an opioid, benzodiazepine, or both (opioid 49.9%, benzodiazepine 26.8%, both 17.1%). The age-standardised death rate in those prescribed gabapentinoids was double that in the Scottish population (relative risk 2.16, 95% confidence interval 2.08–2.25). This study, published in the British Journal of Anaesthesia, lends further weight to concerns already expressed about the potential contributions that pregabalin and gabapentin make in connection to medication-related fatalities – read more here.