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Determining the Toxicological Significance of Pregabalin in Fatalities
Author(s) -
Elliott Simon P.,
Burke Timothy,
Smith Christopher
Publication year - 2017
Publication title -
journal of forensic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.715
H-Index - 96
eISSN - 1556-4029
pISSN - 0022-1198
DOI - 10.1111/1556-4029.13263
Subject(s) - pregabalin , medicine , synthetic cannabinoids , cannabis , pharmacology , drug , forensic toxicology , poison control , anesthesia , psychiatry , emergency medicine , cannabinoid , chemistry , receptor , chromatography
Pregabalin has become more widely prescribed and abused in recent years but is still not always included in laboratory analysis. An LC ‐ MS ‐ MS method has been developed and applied to measure pregabalin in 93 postmortem cases, including drug‐related deaths, alternative causes of death, and fatalities where pregabalin was likely to have contributed to death. Other drugs or alcohol was detected, and the most common drug types (in decreasing frequency) were antidepressants, opioids, benzodiazepines, opiates, alcohol, antipsychotics, cocaine, cardiac drugs, amphetamines, cannabis, anticonvulsants, and antihistamines. New psychoactive substances (methoxphenidine and synthetic cannabinoids) were only found in two cases. The results provide further data to assist in evaluating the significance of postmortem pregabalin concentrations and a toxicologically significant concentration of 25 mg/L is proposed. Pregabalin, especially with concomitant use of other CNS depressant drugs, presents a significant toxicological risk and existing laboratory protocols should be reviewed for their suitability to detect pregabalin.