Miljevic C, Crnobaric C, Nikolic S, Lecic-Tosevski D
Institute of Mental Health, Belgrade.
Psychiatriki. 2012 Apr-Jun;23(2):162-5.
Pregabalin, or S-(+)-3-isobutylgaba, is a lipophilic analogue of GABA. Although pregabalin is structurally related to GABA, it is inactive at GABA receptors and does not appear to mimic GABA physiologically. Pregabalin is a potent ligand for the alpha-2-delta subunit of voltage-gated calcium channels in the central nervous system. It is currently being licensed for epilepsy, neuropathic pain, and generalized anxiety disorder. There are few case reports that have demonstrated safety of pregabalin in case of intoxication. We report here a case of pregabalin toxicity with a moderate pregabalin concentration that was successfully managed with conservative treatment only. The case report describes a 54-year-old man who was treated with pregabalin for generalized anxiety disorder. After having experienced a significant stress on a job the patient ingested huge amount of pregabalin (4,2 r) together with bromazepam (21 mg) and chlorimipramine (125 mg). On presentation he was conscious and alert with a stable condition of cardiovascular and respiratory systems. The serum pregabalin concentration was 20.8 mg/L but the patient did not have any signs of toxicity. Thanks to his good and stable somatic condition the patient was managed with supportive treatment only. Although anecdotal, our case report points toward safety of pregabalin following deliberate self-poisoning. Our observation is in accordance with the recent international literature underlining that pregabalin was listed as the drug ingested in only 1% of fatalities, usually in combination with other drugs.
普瑞巴林，即S-(+)-3-异丁基γ-氨基丁酸，是γ-氨基丁酸（GABA）的亲脂性类似物。尽管普瑞巴林在结构上与GABA相关，但它在GABA受体上无活性，且在生理上似乎不会模拟GABA的作用。普瑞巴林是中枢神经系统电压门控钙通道α-2-δ亚基的强效配体。它目前已获批准用于治疗癫痫、神经性疼痛和广泛性焦虑症。很少有病例报告证明普瑞巴林在中毒情况下的安全性。我们在此报告一例普瑞巴林中毒病例，其普瑞巴林浓度适中，仅通过保守治疗就成功治愈。该病例报告描述了一名54岁男性，因广泛性焦虑症接受普瑞巴林治疗。在工作中经历重大压力后，该患者摄入了大量普瑞巴林（4200毫克）以及溴西泮（21毫克）和氯米帕明（125毫克）。就诊时，他意识清醒，心血管和呼吸系统状况稳定。血清普瑞巴林浓度为20.8毫克/升，但患者没有任何中毒迹象。由于其良好且稳定的身体状况，该患者仅接受了支持性治疗。尽管只是个案，但我们的病例报告表明普瑞巴林在蓄意自我中毒后是安全的。我们的观察结果与最近的国际文献一致，该文献强调普瑞巴林仅在1%的死亡病例中被列为摄入药物，通常是与其他药物联合使用。
