Significant pregabalin toxicity managed with supportive care alone

Area of Science:

• Clinical Toxicology
• Pharmacology

Background:

• Limited case reports exist on pregabalin self-poisoning management.
• Previous reports suggest supportive care and enhanced elimination are viable treatments.
• Reported peak pregabalin concentrations range from 13-60 mg/L.

Observation:

• A 54-year-old male ingested 8.4 g of pregabalin.
• He developed neurological depression and coma 3 hours post-ingestion.
• Serum pregabalin concentration reached 66.5 mg/L during clinical deterioration.

Findings:

• The patient was managed with supportive care, including mechanical ventilation.
• Clinical improvement occurred as consciousness returned.
• This case supports supportive care as a primary management strategy for severe pregabalin toxicity.

Implications:

• Severe pregabalin toxicity can manifest with significant neurological depression.
• Supportive care, including airway management and ventilation, can be effective.
• While extracorporeal methods are pharmacokinetically plausible, supportive care alone may suffice in managing high-concentration pregabalin toxicity.