PREGABALİN DEPENDENCE: A CASE REPORT

Gülay Oğuz; F. Mükerrem Güven; Sedat Batmaz

PREGABALİN DEPENDENCE: A CASE REPORT

Authors

Gülay Oğuz Canik Başarı Üniversitesi
F. Mükerrem Güven Özel Lara Anadolu Hastanesi
Sedat Batmaz Gaziosmanpaşa Üniversitesi, Tıp Fakültesi, Ruh Sağlığı ve Hastalıkları Anabilim Dalı

Keywords:

GABA, prega-balin, substance dependence

Abstract

Pregabalin is a new generation antiepileptic drug that exerts its effects by decreasing the release of neurotransmitters, such as glutamate, noradrenaline, and substance P. Pregabalin is a gamma-aminobutyricacid (GABA) analogue utilized in the treatment of neuropathic pain and generalized anxiety disorder, in addition to epilepsy. There have been studies conducted in recent years demonstrating the effectiveness of Pre-gabalin in the treatment of benzodiazepine and alcohol dependence. However, there have also been cases in which pregabalin dependence developed. As such, pregaba-lin should be used with caution. This article presents a case report of a 27-year-old man who started on pregabalin in order to discontinue synthetic marijuana (Jamaica) use, then abused it and exhibited withdrawal symptoms when not using it. The patient had been taking 2100 mg/day of pregabalin, and stated that he experienced withdrawal symptoms including irritability, shaking, heartburn, inertia, depression, and an inability to work when he hadn’t taken the medicine. His daily dose of pregaba-lin was decreased according to a provided chart and he was started on paroxetine at 20 mg/day, and quetiapine XR at 50 mg/ day. Following this intervention, the patient managed to quit pregabalin within 60 days.

References

Raza S, Siddiqui UA, Megna JL, Schwartz TL, Batki SL. Pregabalin treatment of anxiety in patients with substance use disorders. Ann Pharmacother 2010; 44: 937-8.

Pohl RB, Feltner DE, Fieve RR et al. Efficacy of pregabalin in the treatment of generalized anxiety disorder: double-blind, placebo-controlled comparison of BID versus TID dosing. J Clin Psychopharmacol 2005; 25: 151-8.

Feltner DE, Crockatt JG, Dubovsky SJ et al. A randomized, double-blind, placebo-controlled, fixed-dose, multicenter study of pregabalin in patients with generalized anxiety disorder. J Clin Psychopharmacol 2003; 23: 240-9.

Pande AC, Crockatt JG, Feltner DE et al. Pregabalin in generalized anxiety disorder: a placebo-controlled trial. Am J Psychiatry 2003;160:533-40.

Rickels K, Pollack MH, Feltner DE et al. Pregabalin for treatment of generalized anxiety disorder: a 4-week, multicenter, double-blind, placebo controlled trial of pregabalin and alprazolam. Arch Gen Psychiatry 2005; 62: 1022-30.

Oulis P, Konstantakopoulos G. Pregabalin in the treatment of alcohol and benzodiazepines dependence. CNS NeurosciTher. 2010; 16:45-50.

Guglielmo R, Martinotti G, Clerici M et al. Pregabalin for alcohol dependence: a critical review of the literature. Adv Ther 2012;29:947–57.

Grosshans M, Mutschler J, Hermann D ve ark. Pregabalin abuse, dependence, and withdrawal: a case report. Am J Psychiatry 2010; 167:869.

Filipetto F, Zipp C, Coren J. Potential for pregabalin abuse or diversion after past drug-seeking behavior. J Am OsteopathAssoc 2010;110:605–7.

Yargic I, Alyanak, Özdemiroglu F. Pregabalin abuse: Case report. Bulletin of Clinical Psychopharmacology 2011; 21:64-6.

Carrus D, Schifano F. Pregabalin misuse-related issues; intake of large dosages, drug smoking allegations, and possible association with myositis: Two case reports. Journal of Clinical Psychopharmacology 2012; 32:839-40.

Gabapentin and pregabalin: abuse and addiction. Prescrire Int. 2012 Jun;21(128):152-4.

Gahr M, Franke B, Freudenmann RW et al. Concerns about pregabalin: further experience with its potential of causing addictive behaviors. J Addict Med 2013; 7:147-9.

Gahr M, Freudenmann RW, Hiemke C et al. Pregabalin abuse and dependence in Germany: results from a database query. Eur J Clin Pharmaco 2013; l69:1335–4211.

Schwan S, Sundström A, Stjernberg E et al. A signal for an abuse liability for pregabalin– results from the Swedish spontaneous drug reaction reporting system. Eur J Clin Psychopharmaco 2010; l66:947–53.

Schifano F, Offizi S, Piccione M, Corazza O, Deluca P, Davey Z, et al. Is there a recreational misuse potential for pregabalin? Analysis of anecdotal online reports in comparison with related gabapentin and clonazepam data. Psychother Psychosom. 2011;80(2):118-22.

Chalabianloo F, Schjøtt J. Pregabalin and its potential for abuse. Tidsskr Nor Laegeforen. 2009; 129(3):186-7.

Martinotti G. Pregabalin in clinical psychiatry and addiction: pros and cons. Expert Opin Investig Drugs. 2012; 21(9):1243-5.

Halaby A, Kassam SA, Naja WJ. Pregabalin Dependence: A Case Report. Curr Drug Saf. 2014 Oct 21. [Epub ahead of print]

Papazisis G, Garyfallos G, Sardeli C, Kouvelas D. Pregabalin abuse after past substance seeking behavior. Int. Journal of Clinical Pharmacology and Therapeutics 2013; 51:441-2.

Gahr M,Freudenmann RW, KölleMA,Schönfeldt-Lecuona C. From benzodiazepine to pregabalin dependence: Different agents, similar problems. Indian J Psychiatry. 2015; 57(1): 111–2.

Ashwini S, Amit DR, Ivan NS, Alka PV. Pregabalin dependence with pregabalin induced intentional self-harm behavior: A case report. Indian J Psychiatry. 2015; 57(1): 110–1.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. 2013. Washington: DC.

Hadley SJ, Mandel FS, Schweizer E. Switching from long-term benzodiazepine therapy to pregabalin in patients with generalized anxiety disorder: a double-blind, placebo-controlled trial. J Psychopharmacol 2012; 26:461–70.

PREGABALİN DEPENDENCE: A CASE REPORT