Clinical Toxicology Unit, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.
Br J Clin Pharmacol. 2020 Dec;86(12):2435-2440. doi: 10.1111/bcp.14348. Epub 2020 Jun 5.
With rising use worldwide, pregabalin is increasingly implicated in poisoning deaths. We aimed to investigate the clinical effects and complications of pregabalin poisoning.
This is a retrospective review of patients presenting with pregabalin poisoning to two tertiary toxicology units from 1 July 2014 to 30 June 2019. Patients were identified from prospective databases maintained by both units and data were extracted from these in addition to medical records.
There were 488 presentations in 413 patients (237 [57%] male) over the five-year period. The median age was 41 years (IQR 31-50 years). Deliberate self-poisonings accounted for 342 (70%) presentations, with 121 (25%) recreational exposures. Recreational exposures increased over the period from 2 (4%) in the first year to 54 (39%) presentations in the final year. The median dose of pregabalin was 1200 mg (IQR 600-3000 mg, range 75-16 800 mg). Co-ingestions occurred in 427 (88%) presentations, with sedating agents being co-ingested in 387 (79%)-most commonly opioids and benzodiazepines in 201 (41%) and 174 (36%) presentations respectively. Coma (GCS < 9) occurred in 89 (18%) cases, with 52 (11%) patients being intubated. Only one (0.2%) of these patients had not co-ingested a sedating agent. Hypotension occurred in 26 (5%) cases, all with co-ingestants. Seizures occurred in 11 (2%) cases, 3/59 (5%) in pregabalin-only overdoses. The median length of stay was 16.5 hours (IQR 10-25 hours).
Pregabalin overdose does not cause severe toxicity, but rather mild sedation and, uncommonly, seizures. Coma is common in the presence of sedating co-ingestants. Recreational use is increasing.
随着 pregabalin 在全球范围内的使用增加，它与中毒死亡的关系也越来越密切。本研究旨在调查 pregabalin 中毒的临床影响和并发症。
这是对 2014 年 7 月 1 日至 2019 年 6 月 30 日期间两家三级毒理学单位收治的 pregabalin 中毒患者进行的回顾性研究。通过两个单位的前瞻性数据库识别患者，并从这些数据库和病历中提取数据。
五年间共有 413 例患者的 488 例就诊（237 例[57%]为男性）。中位年龄为 41 岁（IQR 31-50 岁）。故意自我中毒占 342 例（70%），121 例（25%）为娱乐性暴露。在研究期间，娱乐性暴露的比例从第一年的 2 例（4%）增加到最后一年的 54 例（39%）。pregabalin 的中位剂量为 1200mg（IQR 600-3000mg，范围 75-16800mg）。427 例（88%）存在共服药物，镇静剂共服 387 例（79%），最常见的共服药物为阿片类药物和苯二氮䓬类药物，分别为 201 例（41%）和 174 例（36%）。89 例（18%）患者出现昏迷（GCS < 9），52 例（11%）患者进行气管插管。这些患者中只有 1 例（0.2%）没有共服镇静剂。26 例（5%）患者出现低血压，均有共服药物。11 例（2%）患者出现癫痫发作，其中 59 例（5%）pregabalin 单一药物过量患者中有 3 例。中位住院时间为 16.5 小时（IQR 10-25 小时）。
pregabalin 过量不会引起严重毒性，而是轻度镇静，偶尔会引起癫痫发作。昏迷在有镇静剂共服的情况下很常见。娱乐性使用正在增加。
