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UK Government to reclassify pregabalin and gabapentin after rise in deaths

We at Pain Con­cern wish to address the recent arti­cles pub­lished in Pulse Today titled ‘Pre­ga­balin and gabapentin set to become con­trolled drugs’ on the 21st Sep­tem­ber, and the British Med­ical Jour­nal (BMJ) on the 25th Sep­tem­ber 2017 titled ‘UK gov­ern­ment to reclas­si­fy pre­ga­balin and gabapentin after rise in deaths.’

The terms depen­dence and addic­tion are used as if inter­change­able; they are not. With regards to deaths asso­ci­at­ed with these drugs it is entire­ly unclear whether these are due to tak­ing as pre­scribed, tak­ing at dos­es high­er than pre­scribed, tak­en with oth­er (poten­tial­ly addic­tive drugs such as opi­oids) – and there­fore, abuse — or tak­en in increas­ing dos­es alone or in com­bi­na­tion with recre­ation­al drugs and/or alcohol.

We note with con­cern a rise in the num­ber of deaths asso­ci­at­ed with the inges­tion of pre­gabin and gabapentin. It is unclear what pro­por­tion of these were in peo­ple tak­ing these drugs as pre­scribed or abus­ing the drugs by tak­ing exces­sive­ly large dos­es, or in com­bi­na­tion with oth­er pre­scribed or recre­ation­al drugs or alco­hol. We sup­port open and informed dis­cus­sion between patients and their pre­scribers about the like­ly ben­e­fits of treat­ment and poten­tial adverse effects, includ­ing the risks of depen­den­cy, addic­tion and inter­ac­tions with oth­er drugs.

We recog­nise that a sig­nif­i­cant num­ber of peo­ple do not derive ben­e­fit from these drugs even when pre­scribed appro­pri­ate­ly for nerve pain, and would encour­age them to con­sult with their GP about alter­na­tive ways of con­trol­ling their pain. We share the con­cerns of those who are deriv­ing sig­nif­i­cant ben­e­fit from these drugs: that it will prove more dif­fi­cult to get them when they are reclas­si­fied as Con­trolled Substances.

Pain Con­cern is com­mit­ted to the dis­sem­i­na­tion of accu­rate and clin­i­cian approved infor­ma­tion regard­ing the treat­ment of chron­ic pain direct­ly to the patients them­selves. This includes infor­ma­tion on the use and mis­use of pre­scrip­tion drugs. As such, we feel the need to address this issue in the strongest pos­si­ble terms.

Comments

Can’t say I am sur­prised that the clas­si­fi­ca­tion of Gabapentin has been changed. Was pre­scribed by Pain clin­ic some years ago for neu­ro­path­ic pain with amit­ryp­ti­line. Took some time to tol­er­ate effects from Gabapentin. Ami not so bad. Decid­ed ear­li­er this year that I had enough of feel­ing dazed all the time. GP did­n’t like them at all. So reduced dose slow­ly. But with­draw­al symp­toms are awful. Sweat­ing and sleep­less­ness bad for over a month. Three months down the line I feel clear­head­ed again. Unfor­tu­nate­ly pain lev­els are bad. Use tra­madol with parac­eta­mol. Naprox­en and amit­ryp­ti­line at night. Don’t want to take them again.. Gabapentin I mean. But GP does­n’t like to pre­scribe tra­madol which I was tak­ing with Oromorph…which works well to keep pain lev­els down with few side effects. Anti depres­sants no good… Feel too sedat­ed with them but pain still there. I had heard a cou­ple of years ago that there is a mar­ket for Gabapentin for recre­ation­al use. They must be nuts. But it is unfair for any health pro­fes­sion­al to refuse to pre­scribe any of these meds because a few peo­ple mis­use them. Many peo­ple would love to not need pain relief…its not a choice you make to have ongo­ing severe pain. I’ve tried on meds and its not good to feel so much pain all the time. CBT etc etc etc do have a place but it isn’t always the answer.

I have trigem­i­nal neu­ral­gia, also known as The Sui­cide Dis­ease. In my view, it is not a dis­ease, but a con­di­tion, one that dom­i­nates life, despite the patien­t’s aware­ness that they are not ill, but in pain, excru­ci­at­ing pain. Cur­rent­ly, I am on gabapentin, and allowed to self-titrate with­in lim­its, max­i­mum being 3600 mg per day. I have nev­er had to go that high. The accept­ed drug for this con­di­tion is not gabapentin. I have tried the alter­na­tive, but it caus­es severe headache, nau­sea, detached­ness, whilst hav­ing no effect what­ev­er on the pain. What will patients such as I do if this drug goes to class 3? It will con­demn me to a life­time of the most severe pain imag­in­able. Trigem can­not be cured, although there are some pro­ce­dures that help some but not all suf­fer­ers. It is far from clear whether a pro­ce­dure (brain surgery) will help me, or any­one else. 

Even dur­ing spells of remis­sion, trigem­i­nal neu­ral­gia stalks silent­ly after every patient who lives with per­sis­tent vig­i­lance against trig­gers and the ter­ror this dis­gust­ing con­di­tion will return.

It is unre­lent­ing and in my case the only relief I have is with gabapentin, which has no effect on my mood, apart from grat­i­tude. I cer­tain­ly don’t feel “high” or even odd. 

I beg beg this con­sul­ta­tion falls through.

I was tak­ing Gabapentin for a few years. I attend­ed the Pain Clin­ic look­ing for alter­na­tives, eg. Acupunc­ture, Tens, etc but the Con­sul­tant at the Pain Clin­ic told me to just stop tak­ing every­thing. As well as Gabapentin (600mg x 3 per day) I was tak­ing Amitripty­line 100mg, Lodine, Parac­eta­mol & also on Buprenor­phine patch­es. I was hor­ri­fied as I knew you shouldn’t just stop your med­ica­tion. He insist­ed that I should see a phys­io­ther­a­pist (for breath­ing exer­cis­es, pac­ing & Mind­ful­ness) and he wrote to my doc­tor. The out­come of stop­ping the Gabapentin caused me so many with­draw­al symp­toms. I felt as though I had a bad case of flu which felt as though it would nev­er end. Luck­i­ly I had enough patch­es to taper down but I would nev­er wish to repeat that!
I did have to leave the pain clin­ic even­tu­al­ly after ask­ing if I could have Acupunc­ture etc. but was told I wasn’t tak­ing this seri­ous­ly and I should go home and read my Mind­ful­ness notes.
Any­way, I saw my Rheuma­tol­o­gist last week and he asked me why I’d stopped the Gabapentin. When I told him, he repre­scribed them. I thought they’d been asked to stop pre­scrib­ing it so I was sur­prised. I’m just wait­ing for my gp prac­tice to refuse!
I’m real­ly hap­py for the peo­ple that find that Mind­ful­ness helps their pain but I’m afraid that no amount of it helped me.
As has already been said, why should so many peo­ple be denied Pre­ga­balin & Gabapentin when they need them, just because a few peo­ple abuse them?

I was yelled at by my GP when I told her I re-start­ed my Pre­ga­balin. Now, of course 111 peo­ple died from this med­ica­tion, of course if you com­bine coke and lyri­ca you will die…from the cocaine !
I have zero inter­est in tak­ing nar­cotics and am hap­py to stay on Ami which caused me severe neu­ro­log­i­cal fatigue when stopped for a year, but at least when I am on it …it’s actu­al­ly amitripty­line that I find addic­tive, I was able to with­draw very eas­i­ly from Pre­gab in the past, which is a mir­a­cle pill for nerve pain anyway …
Mind­ful­ness helps the med­ica­tion work faster, that is true, but who can stay “mind­ful” with dai­ly stres­sors any­way ? It is not pow­er­ful enough to war­rant dis­con­tin­u­a­tion of treatment.
We pay so much tax and we have zero in return, apart from incom­pe­tence and dis­as­trous chaot­ic polit­i­cal decisions

I have ser­vere spinal steno­sis at c5 c6 and at l4 and ive been com­plain­ing of pain for years and its only after com­plain­ing to nhs eng­land did my gp arrange for a mri…the gp after a lot of has­sle agreed to pre­scribe diazepam and tramadol…ive seen doc­tors pri­vate­ly who sug­gest­ed noritri­ti­pline and then if that does­nt do the trick then pre­gablin. My cousin sis­ter is a doc­tor abroad and she sug­gests gabapentin to be most effec­tive. I just find it so much has­sle to get my gp to pre­scribe any­thing but naprox­en. The diazepam does­nt help much and the tra­madol start­ed to beome less effec­tive at 100 mg. i cur­rent­ly take noritrip­ti­line 25mg at night. It makes me feel paranoid.

Comments are closed.

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