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Induction of Ocular Surface Inflammation and Collection of Involved Tissues
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Pregabalin and Its Involvement in Coronial Cases.

Amanda Thompson1, Sarah Morey1, Andrew Griffiths1

  • 1Forensic & Scientific Services, Health Support Queensland, Australia.

Journal of Analytical Toxicology
|May 17, 2019
PubMed
Summary

Pregabalin, used for pain and seizures, is increasingly detected in Australian coronial cases, often with other drugs. Most deaths involving pregabalin were drug-related, frequently due to mixed drug toxicity.

Area of Science:

  • Forensic Toxicology
  • Pharmacology
  • Public Health

Background:

  • Pregabalin is an anticonvulsant and analgesic prescribed in Australia since 2005.
  • Recreational use and self-management of opioid withdrawal are reported uses.
  • Increased pregabalin detections in coronial cases have been observed.

Purpose of the Study:

  • To examine case characteristics and outcomes of coronial cases involving pregabalin.
  • To analyze the frequency and context of pregabalin detection in post-mortem investigations.

Main Methods:

  • Development and validation of a protein precipitation and LC/MS/MS method for pregabalin analysis.
  • Analysis of 332 coronial cases submitted between 2015 and 2017.
  • Review of case characteristics, concurrent drug use, and cause of death.

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Main Results:

  • Pregabalin was detected in approximately 5% of all coronial cases during the study period.
  • High rates of concurrent drug use were observed, primarily opioids, benzodiazepines, and antidepressants.
  • Drug-related deaths accounted for 58% of cases, with mixed drug toxicity cited in 40%.

Conclusions:

  • Pregabalin is frequently detected in coronial cases, often in conjunction with other central nervous system depressants.
  • The findings highlight the association of pregabalin with drug-related mortality, particularly mixed drug toxicity.
  • Further research is needed to interpret post-mortem pregabalin concentrations due to frequent co-ingestion.