Use of Pregabalin - A Nationwide Pharmacoepidemiological Drug Utilization Study with Focus on Abuse Potential

Pharmacopsychiatry. 2016 Jul;49(4):155-61. doi: 10.1055/s-0042-101868. Epub 2016 Mar 7.

Abstract

Introduction: Pregabalin is currently approved for the treatment of epilepsy, generalized anxiety disorder and neuropathic pain with a licensed dosage range of 150 mg to 600 mg/day. Growing concern about the abuse potential of pregabalin is partly based on reports of pregabalin being used in dosages that exceed the approved therapeutic range.

Methods: To identify predictors of pregabalin use above recommended dosage, we conducted a pharmacoepidemological drug utilization study using the Danish nationwide registers. We deployed 4 measures of abuse: high use (≥600 mg/day) or very high use (≥1 200 mg/day) over a 6- or 12-month period, respectively. Multiple logistic regression was used to identify patient and treatment characteristics that were associated with either abuse marker.

Results: Out of 42 520 pregabalin users 4 090 (9.6%) were treated with more than 600 mg/day for 6 months and 2 765 (6.5%) for more than 12 months. Male gender and prescription of antipsychotics and benzodiazepines were associated with increased risk of use of above the recommended dosage.

Discussion: Use of pregabalin above recommended dosages was rare but abuse may occur in susceptible patients.

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Anticonvulsants / adverse effects*
  • Antipsychotic Agents / therapeutic use
  • Denmark / epidemiology
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Pregabalin / adverse effects*
  • Prescription Drug Misuse / adverse effects
  • Retrospective Studies
  • Substance-Related Disorders / drug therapy
  • Substance-Related Disorders / epidemiology*
  • Substance-Related Disorders / etiology*

Substances

  • Anticonvulsants
  • Antipsychotic Agents
  • Pregabalin