Misuse of gabapentinoids (pregabalin and gabapentin) in patients with neuropathic pain related to spinal cord injury

The Journal of Spinal Cord Medicine, 2023 · DOI: 10.1080/10790268.2021.2024709 · Published: July 1, 2023

Simple Explanation

This study investigates the misuse of gabapentinoids (pregabalin and gabapentin) among patients with neuropathic pain related to spinal cord injury (SCI). Gabapentinoids are commonly prescribed for this type of pain, but there are concerns about their misuse. The study found that a significant percentage of patients using these medications were misusing them, according to DSM-5 criteria for substance-related disorders. Specifically, misuse was more prevalent among those taking pregabalin compared to gabapentin. The researchers identified factors such as the duration of the condition and the severity of neuropathic pain as being associated with a higher likelihood of misuse. They suggest that clinicians should be cautious when prescribing these drugs to patients with SCI.

Study Duration

Not specified

Participants

127 patients aged 18–70 years with neuropathic pain related to spinal cord injury

Evidence Level

Cross-sectional study

Key Findings

1
The misuse rate was 81.9% in patients using pregabalin and 69.69% in patients using gabapentin.
2
Duration of disease and the Leeds assessment of neuropathic symptoms and signs (LANSS) score were statistically significantly higher in the drug misuse group.
3
A statistically significant relationship was observed between drug misuse and duration of disease and LANSS score.

Research Summary

This study investigated the misuse of gabapentinoids in patients with neuropathic pain related to spinal cord injury, finding a high prevalence of misuse, particularly with pregabalin. The study identified that longer disease duration and greater neuropathic pain severity were associated with increased misuse. The researchers recommend caution when prescribing gabapentinoids to patients with spinal cord injury, emphasizing the need to investigate factors related to misuse.

Practical Implications

Clinical Caution

Clinicians should be cautious when prescribing gabapentinoids to patients with SCI due to the high prevalence of misuse.

Risk Factor Assessment

Assess patients for risk factors such as disease duration and severity of neuropathic pain before and during gabapentinoid treatment.

Further Research

More research is needed to explore the factors contributing to gabapentinoid misuse in this population, including the level of SCI lesion and the level of NP lesion.

Study Limitations

1
The patients with SCI were not grouped according to the level of the lesion (cervical, thoracic, lumbosacral) and the level of NP according to the lesion (at the lesion level and below).
2
Another important limitation was our lack of inquiry on the sleep disturbance and anxiety that accompanied NP.
3
Another limitation was the small number of patients.

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