Gabapentin and Pregabalin Overdoses and Their Management: An Update

Gabapentinoids are increasingly prescribed and utilized to treat various disorders, including neuropathic pain, post-herpetic neuralgia, and fibromyalgia. This article aims to highlight the advantages and disadvantages of gabapentinoids, specifically gabapentin and pregabalin, and address advancements and areas for improvement in the topic.

A systematic search was conducted to identify studies related to the issue in the literature. All English- language studies from 2005 to 2025 focusing on the effectiveness and safety profiles of the compounds were abstracted following searches in Google Scholar, PubMed, Scopus, Web of Science, and MEDLINE. Editorials, expert opinions, and retrospective studies were excluded from the analysis.

These agents have been beneficial in cutting down the rates of opioid prescriptions. Many research studies showed that pregabalin prescription increased linearly over time, together with co-prescription with opioids in a substantial portion (more than one-fourth) of the total numbers. Lethal intoxications are mostly those with concurrent intake of other substances, especially opioids.

Although gabapentinoids are getting wider recognition and are used more commonly worldwide in recent decades, clinicians should be aware of the inherent hazards of the agents. Decision-making algorithms and guidelines should address the pros and cons of this group in comparison to opioids and other alternatives in pain management in special groups, such as those with organ failures and important comorbidities.

Prescribers of gabapentinoids need to pay attention to the use of these agents in special groups at high risk, and findings indicative of misuse and/or abuse have to be monitored properly.