[Alarming Pregabalin Abuse in Munich: Prevalence, Patterns of Use and Complications]

Background Pregabalin is used e. g. for the treatment of neuropathic pain and anxiety disorder. Recently, its potential for abuse and addiction has become apparent. Methods From 2008 - 2015, we searched our database for the term "Pregabalin", including all patients treated in our department and all calls to the Poison Information Centre (PIC) Munich.From October 2013 to September 2014, all patients were included in a cohort study who either were admitted with a drug intoxication or who presented themselves for a course of detoxification (except ethanol). Results From 2008 - 2015, 263 patients with Pregabalin abuse were treated. The number of cases per year increased from 0 - 5 in 2008 - 2011 to 105 in 2015. In 2008, the PIC received 3 calls concerning Pregabalin abuse, in 2015 the number of calls was 71. From 2013 - 2014, 80 out of 370 patients had consumed Pregabalin. It was the fifth most frequently abused substance. Pregabalin users had consumed more additional substances than other patients (median 4 1 2 3 4 5 6 vs. 2 1 2 3 4 5 6, p < 0.001) and they were more often in an opioid substitution treatment (41.2 vs. 21.7 %, p < 0.001).The most co-abused drugs were benzodiazepines (66.3 %), methadone (48.8 %), buprenorphine (32.5 %) and heroin (22.5 %). 88.0 % of all intoxicated patients had moderate to severe symptoms of intoxication like impaired consciousness (74.0 %), respiratory distress, (40.0 %), agitation/aggressiveness (28.0 %), restlessness (14.0 %), hallucinations (8.0 %) or seizures (8.0 %).The semi-quantitative urine concentration was 51.4 ± 66.0 mg/g Creatinine for intoxicated patients and 26.1 ± 23.0 for patients admitted for detoxification (n = 58; p = 0.034). Discussion Pregabalin abuse increases continuously and constitutes a significant health issue. Particularly patients with a history of substance abuse are vulnerable. Physicians should be aware of the substantial potential of Pregabalin for abuse and addiction and they should know the dangers of an intoxication.