In the United States, the Food and Drug Administration (FDA) has approved pregabalin for adjunctive therapy in adults with partial seizures, the treatment of postherpetic neuralgia and neuropathic pain associated with spinal cord injury and diabetic peripheral neuropathy, and the treatment of fibromyalgia. [110] Pregabalin has also been approved in the European Union, the United Kingdom, and Russia for the treatment of generalized anxiety disorder. [100] [46] [111] Pregabalin is an analogue of GABA that is both a 3-substituted derivative and an amino acid γ. [14] [70] In particular, pregabalin (S) – (+) – 3-isobutyl-GABA. [88] [89] [90] Pregabalin is also very similar to the amino acids α L-leucine and L-isoleucine, which may be more relevant in terms of pharmacodynamics than structural similarity to GABA. [76] [77] [88] Those who use pregabalin in leisure time call it “Budweiser” because it causes a condition similar to drunkenness. It makes users relaxed and euphoric, similar to tranquilizers. It can also enhance the euphoric effects of other drugs such as opiates and probably increase the risks when taken this way. Chemical syntheses of pregabalin have been described.
[91] [92] Gabapentin and pregabalin, two widely used prescription drugs, are now subject to increased controls in the United Kingdom, meaning they are now classified as Class C controlled substances. It is not safe to take pregabalin without a prescription. It is also dangerous to take pregabalin with alcohol and other drugs. Alcohol and some drugs compress the central nervous system, which affects a person`s breathing. Drugs that do this include: Pregabalin is available as a generic in a number of countries, including the United States since July 2019. [18] [23] [100] In the United States, the wholesale/pharmacy cost of generic pregabalin is $0.17 to $0.22 per 150 mg capsule in July 2019. [101] One of the reasons these drugs are particularly harmful is the practice of combining them with other drugs to enhance the desired effects. For example, the use of gabapentin and pregabalin with heroin may enhance their euphoric effects. Unfortunately, this also increases the risk of harm, as the suit can cause breathing difficulties and reverse the tolerance the body may have built up to heroin`s effects on breathing. This increases the risk of respiratory failure, which underlies many heroin overdose deaths. Significant abuse of pregabalin has been reported.
Given the above, and given the known effects of pregabalin, it seems possible that addiction may develop in some regular users. It is possible that this happened with tramadol given the increase in the use of gabapentin and pregabalin – as it became more difficult for people to obtain, they found gabapentin and pregabalin easier to obtain, so they became desirable alternatives. This suggests that the new restrictions on gabapentin may transfer the problem to another drug, although it is likely that it is the same group of high-risk people who are most affected. The problem is that we don`t know what drug it will be, and we probably won`t understand it until the same prescription and mortality data provide new information. Pregabalin overdose usually consists of severe somnolence, severe ataxia, blurred vision, slurred speech, severe uncontrollable jerky movements (myoclonus), tonic-clonic seizures and anxiety. [64] Despite these symptoms, overdose is generally not fatal unless mixed with another sedative. Several people with kidney failure developed myoclonus while receiving pregabalin, apparently as a result of the gradual accumulation of the drug. Acute overdose can manifest as drowsiness, tachycardia and hypertension. Plasma, serum or blood concentrations of pregabalin may be measured to monitor treatment or confirm a diagnosis of poisoning in hospitalized individuals. [65] [66] [67] Rachel Britton, Chief Pharmacist of Addaction, stated: “The associated deaths will be people taking a cocktail of substances that affect the central nervous system, such as heroin, pregabalin and benzodiazepines.
It eventually suppresses breathing, which is controlled by the brain, and the people who take these cocktails die. “We have accepted in principle the advice of the Advisory Council on the Misuse of Drugs on the control of pregabalin and gabapentin as Class C medicines, subject to the results of a public consultation to assess the impact on the health sector.