Private Clinic Meiringen, Willigen, Switzerland.
Faculty of Medicine, University of Zurich, Zurich, Switzerland.
Front Public Health. 2024 Jan 8;11:1309654. doi: 10.3389/fpubh.2023.1309654. eCollection 2023.
Pregabalin is a gamma-aminobutyric acid (GABA) analog that was approved in the EU in 2004 for the treatment of neuropathic pain, generalized anxiety disorder and epilepsy. Since its introduction, pregabalin abuse and misuse has increased significantly. In Switzerland, clinical reports suggest that pregabalin misuse is common among patients in forensic hospitals and prisons. However, data on pregabalin use is scarce, especially in these settings. Therefore, we conducted a study to explore patterns of pregabalin use among prison and forensic patients.
We used a questionnaire to survey physicians working in prison and forensic medicine in German-speaking countries. A total of 131 responses were received.
According to the physicians' subjective assessment, 82.5% of them had observed a recent increase in pregabalin use by their patients and 89.1% of them reported that their patients requested pregabalin without a clear medical indication. Patients misusing pregabalin in combination with other illicit substances were observed by 93.3% of the physicians surveyed. According to 73.5% of the physicians surveyed, they had already encountered patients on pregabalin doses of more than 600 mg/day (the maximum recommended daily dose); the highest dose reported was 4,200 mg/day. According to 85.0% of physicians surveyed, they have observed patients experiencing withdrawal symptoms from pregabalin, with the most commonly reported symptoms being displeasure and high aggression. Regarding the nationality of pregabalin-misusing patients, 58.3% of the interviewed physicians reported to be rather in contact with foreign patients, mainly from Northwest Africa (Maghreb). Only 45.0% of the surveyed physicians prescribe pregabalin. Among patients who developed behavioral problems while taking pregabalin, none of the physicians (0.0%) showed a tendency to continue pregabalin at the same dose; all respondents chose to reduce/substitute/discontinue.
Our study has provided confirmatory evidence that the use of pregabalin presents a significant issue in forensic and prison medicine across German-speaking countries. Prescribing pregabalin in this field can compound use disorder problems and exacerbate challenges in daily life for those in forensic institutions or prisons. It is necessary that all physicians who prescribe pregabalin are clearly informed about the management (including the risks) of this drug.
普瑞巴林是一种γ-氨基丁酸（GABA）类似物，于 2004 年在欧盟被批准用于治疗神经性疼痛、广泛性焦虑症和癫痫。自上市以来，普瑞巴林的滥用和误用显著增加。在瑞士，临床报告表明，在法医医院和监狱中，普瑞巴林的滥用较为常见。然而，关于普瑞巴林使用的数据很少，尤其是在这些环境中。因此，我们进行了一项研究，以探讨监狱和法医患者中普瑞巴林的使用模式。
我们使用问卷对德语国家的监狱和法医医生进行了调查。共收到 131 份回复。
根据医生的主观评估，82.5%的医生观察到近期患者使用普瑞巴林的情况有所增加，89.1%的医生报告说他们的患者在没有明确医疗指征的情况下要求使用普瑞巴林。接受调查的医生中有 93.3%观察到患者将普瑞巴林与其他非法物质混合使用。根据 73.5%的医生的说法，他们已经遇到了每天服用超过 600 毫克普瑞巴林（推荐的最大日剂量）的患者；报告的最高剂量为 4200 毫克/天。根据 85.0%的医生的说法，他们观察到患者出现了戒断症状，最常见的症状是不愉快和高度攻击性。关于滥用普瑞巴林的患者的国籍，接受调查的医生中有 58.3%报告说与外国患者（主要来自北非马格里布地区）接触较多。只有 45.0%的调查医生开普瑞巴林处方。在服用普瑞巴林出现行为问题的患者中，没有医生（0.0%）有继续开相同剂量普瑞巴林的倾向；所有受访者都选择减少/替代/停止。
我们的研究提供了确凿的证据，表明普瑞巴林在德语国家的法医和监狱医学中是一个重大问题。在这一领域开普瑞巴林处方会加重药物使用障碍问题，并加剧法医机构或监狱中人员的日常生活挑战。所有开普瑞巴林处方的医生都必须明确了解该药物的管理（包括风险）。
