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Patterns of gabapentin and pregabalin use and misuse: Results of a population‐based cohort study in France
Author(s) -
Driot Damien,
Jouanjus Emilie,
Oustric Stéphane,
Dupouy Julie,
LapeyreMestre Maryse
Publication year - 2019
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/bcp.13892
Subject(s) - pregabalin , medicine , gabapentin , duloxetine , population , hazard ratio , cohort , confidence interval , proportional hazards model , anesthesia , environmental health , alternative medicine , pathology
Aims The aim of this study was to assess the use and factors associated with the misuse of gabapentin and pregabalin in the general French population, through a cohort study in the EGB (General Sample of Beneficiaries), a national representative sample of the French general population. Methods New users of gabapentin and pregabalin were identified from June 2006 to December 2014, and new users of duloxetine served as control group. Misuse was defined as a use of higher daily doses than recommended. Cox proportional hazard regression models were performed to identify associated factors of misuse. Results Misuse was more frequent in the 8692 new users of pregabalin (12.8%) than in the 1963 gabapentin (6.6%) or the 3214 duloxetine new users (9.7%) ( P < 0.001). Factors associated with misuse were pregabalin (hazard ratio [HR] 1.48; 95% confidence interval [CI] [1.29–1.69]), age (HR [18–45] versus > 70 years 1.98 [1.70–2.31] and HR [58–70] versus > 70 years 1.25 [1.06–1.47]), multiple prescribers (HR 2 or 3 versus 1 prescriber 1.29 [1.15–1.45]; HR 4 or more versus 1 prescriber 1.54 [1.30–1.83]), cancer (1.28 [1.11–1.47]), multiple sclerosis (1.53 [1.07–2.18]), neuropathy (1.85 [1.19–2.89]), depression (1.26 [1.07–1.49]) and methadone (2.61 [1.16–5.84]). After this first episode of drug misuse, 11.6% of gabapentin and 10.7% of pregabalin misusers developed a primary addiction. Conclusion In a cohort of new users, misuse is more likely to occur in new users of pregabalin, with different associated factors of misuse compared to gabapentin and duloxetine. Health professionals and prescribers must be aware of this misuse potential, which could lead to abuse and dependence.