Pregabalin concentrations in post-mortem blood—A two year study

Abstract

Pregabalin (PRG) is indicated for the treatment of neuropathic pain, epilepsy and generalised anxiety disorder. Limited data exists on reference blood concentrations for this drug and levels above which death can be attributed to PRG toxicity. Furthermore, there is increasing evidence that the drug is subject to abuse. This study reviews the post-mortem blood concentrations of PRG analysed in the authors’ laboratory between 2012 and 2014 in order to try and assign the likely therapeutic and fatal ranges. PRG was detected in 70 post-mortem blood samples of which 33% were at concentrations considered to be in excess of the reference range (above 17mg/L). PRG concentrations ranged from 0.05mg/L to 226mg/L (median 8.0mg/L) in the group as a whole and in one case a PRG concentration of 76mg/L was determined to be the likely cause of death as no other drugs of significance were involved. The results from this study are consistent with the scientific literature with respect to a high frequency of multidrug use, particularly with opioids/opiates which can increase the probability of a fatal outcome.