Case report

https://doi.org/10.24869/psyd.2018.142

ON THE ADDICTIVE POWER OF GABAPENTINOIDS: A MINI-REVIEW

Udo Bonnet orcid.org/0000-0002-2592-8337 ; Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Evangelisches Krankenhaus Castrop-Rauxel, Academic Teaching Hospital of the University of Duisburg-Essen, Castrop-Rauxel, Germany; LVR-Hospital Essen, Department of Psychiatry and Psychot
Emily-Lisa Richter ; Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Evangelisches Krankenhaus Castrop-Rauxel, Academic Teaching Hospital of the University of Duisburg-Essen, Castrop-Rauxel, Germany
Katrin Isbruch ; Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Evangelisches Krankenhaus Castrop-Rauxel, Academic Teaching Hospital of the University of Duisburg-Essen, Castrop-Rauxel, Germany
Norbert Scherbaum ; LVR-Hospital Essen, Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany

Abstract

The gabapentinoids gabapentin and pregabalin have been related to addiction citing pharmacovigilance data, some case
presentations and increasing reports mainly from methadone maintenance treatment programs or emergency medicine. Most of these
reports were based on patients with another current or previous substance use disorder (SUD). According to the ICD-10 dependence
criteria, physical dependence (withdrawal symptoms, tolerance) was reported most frequently alongside regular use of
gabapentinoids. Far less patients showed key symptoms of behavioral dependence (craving, loss of control, or addictive behavior).
Through a literature review, we found 2 and 13 case reports about gabapentionoid-seeking behavior or craving for gabapentin and
pregabalin, respectively. Those patients without a history of another SUD, but being behaviorally dependent on gabapentinoids,
deemed more appropriate to reflect the true addictive power of these drugs. We found solely 4 such cases, all referring to pregabalin
and none for gabapentin. Taking into account that gabapentinoids have become widely distributed and easily obtainable via the
internet or black-markets, one would expect many more of these cases, if gabapentinoids had considerable addictive power.
Moreover, we are not aware of any patient who sought detoxification treatment owing to the misuse of gabapentinoids. Unlike for
traditional psychoactive drugs, there is only very scarce evidence for gabapentinoids to be misused in a long-term manner and to be
rewarding and reinforcing in animal experiments. Further, we assessed the hazardous potential of gabapentin and pregabalin in
relation to that of traditional substances of abuse. Altogether, we support the view that gabapentinoids are quite rarely addictive in
the general population. In patients with a history of SUD, however, gabapentinoids (notably pregabalin) should avoided or, if
thought to be beneficial, administered with caution by using a strict prescription and therapy monitoring.

Keywords

gabapentin; pregabalin; addiction; abuse; dependence; wanting; liking; ranking; adverse effects

Hrčak ID:

202057

URI

https://hrcak.srce.hr/202057

Publication date:

26.6.2018.

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