Gabapentinoid treatment is associated with an increased risk of suicidal behaviour, unintentional overdose, injuries, and road traffic incidents, particularly among young people.
Results from a Swedish observational study suggest that treatment guidelines for drugs such as such as pregabalin and gabapentin in epilepsy and neuropathic pain should be reviewed, according to an article published in the BMJ.
An international team of researchers, sought to examine associations between gabapentinoids and adverse outcomes related to coordination disturbances (head or body injuries, or both and road traffic incidents or offences), mental health (suicidal behaviour, unintentional overdoses), and criminality.
In a population-based cohort study they analysed prescription, patient, death, and crime registers for 191, 973 people from the Swedish Prescribed Drug Register who collected prescriptions for gabapentinoids (pregabalin or gabapentin) during 2006 to 2013.
The study subject were using gabapentinoids for epilepsy (n= 10,891), psychiatric disorders (n= 61, 526), or musculoskeletal disorders (n= 91,932).
After adjusting for potential confounding factors, gabapentinoid treatment was associated with increased hazards of suicidal behaviour and deaths from suicide (age adjusted hazard ratio 1.26), unintentional overdoses (HR 1.24), head/body injuries (HR 1.22), and road traffic incidents and offences (HR 1.13).
There were no statistically significant associations between gabapentinoid treatment and violent crime (HR 1.04).
When drugs were examined separately, only pregabalin, not gabapentin, was associated with increased risks of harm. Pregabalin treatment was associated with increases in all outcomes for younger participants (15-34 years), and suicidal behaviour, unintentional overdoses, and head/body injuries for those aged 35 to 44.