Pregabalin Associated with Suicidality, Other Adverse Outcomes, Among the Young

This is for our pain practitioners to know about.

By Joe Elia

A study of gabapentinoid use finds pregabalin — but not gabapentin — associated with increased suicidality in young adult patients, according to a report in The BMJ. The drug class has anticonvulsant properties but is increasingly prescribed as an analgesic.

Researchers used Swedish national databases to track gabapentinoid prescriptions and subsequent outcomes in some 200,000 patients aged 15 and older during an 8-year span. Risks for suicidal behavior, traffic accidents, overdoses, and injuries were compared during periods when patients were taking the drugs, versus when they weren’t. The authors say this “within-individual” comparison minimized confounding.

Compared with off-treatment periods, on-treatment periods with pregabalin were associated with significantly increased hazard ratios for all adverse outcomes; gabapentin, on the other hand, showed no increased risks. The risks with pregabalin were especially increased among patients aged 15 to 24.

Of note, the authors did not have information on indications for the medication, and an editorialist points out that the role of “alcohol and illicit drug use … could not be determined.”