Kuhn Dominique, Müller Thomas Jörg, Mutschler Jochen
Universität Zürich Medizinische Fakultät.
Privatklinik Meiringen.
Fortschr Neurol Psychiatr. 2021 Nov;89(11):553-561. doi: 10.1055/a-1324-3379. Epub 2021 Jan 13.
Pregabalin was first approved in 2004 for the treatment of peripheral neuropathic pain and focal epileptic seizures, with or without secondary generalization. Prescription frequency has increased significantly since approval. In the early days, little attention was paid to the problem of misuse and dependence on pregabalin; in recent years, there has been a significant increase in the number of publications focusing on this problem. This review deals with these risk factors and risk groups of pregabalin abuse and dependence in different European countries and their drug policies.
Pregabalin abuse and dependence has increased significantly since its introduction to the market. It was shown that solo abuse of pregabalin is rare. In most cases, pregabalin was combined with other substances, which is also a predictor of pregabalin abuse. There were different reasons for the non-prescription use of pregabalin; it was used to increase the psychotropic effect, on the one hand, and to alleviate withdrawal symptoms, on the other hand. Furthermore, in Sweden, pregabalin was found in 28% of fatal intoxications among drug addicts. Young people were particularly affected. Abuse of pregabalin was detected in countries with restrictive substitution programmes, while in countries with liberal drug policies, no abuse was detected. However, the data situation in Switzerland with a liberal substitution programme is based on only one study, which is why pregabalin use in liberal substitution programmes cannot be conclusively clarified.
There seems to be a connection between a country's drug policy and the illegal use of pregabalin among persons in a substitution programme in that country. There are also risk factors and risk groups for pregabalin dependence and abuse.
普瑞巴林于2004年首次获批用于治疗周围神经性疼痛和局灶性癫痫发作(不论是否伴有继发性全身性发作)。自获批以来,其处方频率显著增加。在早期,人们很少关注普瑞巴林的滥用和依赖问题;近年来,关注该问题的出版物数量大幅增加。本综述探讨了欧洲不同国家普瑞巴林滥用和依赖的这些风险因素、风险群体及其药物政策。
自普瑞巴林上市以来,其滥用和依赖情况显著增加。研究表明,单独滥用普瑞巴林的情况很少见。在大多数情况下,普瑞巴林与其他物质联合使用,这也是普瑞巴林滥用的一个预测因素。非处方使用普瑞巴林有不同原因;一方面是为了增强精神作用,另一方面是为了缓解戒断症状。此外,在瑞典,吸毒成瘾者中28%的致命中毒案例中发现了普瑞巴林。年轻人受影响尤为严重。在实施限制性替代方案的国家检测到了普瑞巴林滥用情况,而在实施宽松毒品政策的国家未检测到滥用情况。然而,瑞士实施宽松替代方案的相关数据仅基于一项研究,这就是为何无法最终明确普瑞巴林在宽松替代方案中的使用情况。
一个国家的药物政策与该国替代方案中人员非法使用普瑞巴林之间似乎存在关联。普瑞巴林依赖和滥用也存在风险因素和风险群体。