A prospective observational study to assess drug aberrant behaviours in chronic pain patients on gabapentinoids

Abstract

Aim: The aim is to explore whether addiction or drug aberrant behavior exists among patients being treated with pregabalin or gabapentin in our outpatient service. Methods: A self-administered questionnaire, the current opioid misuse measure (COMM) was distributed to all patients attending the outpatient service. They filled this voluntarily with maintenance of complete anonymity and confidentiality. Statistical analysis was conducted using the SPSS software. Results: A total of 52 questionnaires were received. Twenty-one patients were on gabapentin and 19 on pregabalin. Eighty percent of the patients had little or no benefit and yet an attempt to taper the doses was made only in 37.8% patients. About 56.9% patients had COMM scores above 9, the cut off value for detecting drug abuse/misuse. The COMM scores showed a positive association with the dose magnitude of gabapentin (P = 0.006) but not pregabalin. They also showed a significant positive correlation with the duration of treatment with pregabalin (P = 0.000). The Mann–Whitney U-test showed that the COMM scores were significantly higher in the pregabalin group (P = 0.022). Conclusions: Our findings suggest gabapentinoids do carry a potential risk of addiction. Pregabalin more than gabapentin may have a potential for drug aberrant behavior. We must regularly review patient's doses and duration of treatment. Large scale studies are needed to validate the findings. Setting up of national pharmacovigilance databases may be the way forward in preventing a potential drug abuse problem.