To investigate efficacy and safety data regarding Gabapentinoids (GBPs) in the setting of a Neuropathic Pain Unit, specifically aiming to reveal any use disorder or abuse behaviour related to the prescription of these medications.
Pregabalin and gabapentin are increasingly prescribed for various clinical conditions. However, concerns about their potential for misuse and abuse have emerged in recent years. Given their approved and off-label uses, it is essential to identify patients at risk for such issues.
A continuous series of patients referred to the Neuropathic Pain Unit at the Department of Human Neuroscience, Sapienza University of Rome, were recruited. All the patients underwent a structured questionnaire aimed at assessing the main aspects of the GBPs treatment: clinical history, comorbidities, the pain condition, S-DN4, GBP treatment information, adverse events, efficacy, use disorder.
331 patients were recruited, 213 on pregabalin and 118 on gabapentin.
157 patients (47.4%) reported gabapentinoids related adverse events, but most of them did not discontinue therapy (92%).
Most patients reported an improvement in pain symptoms (77.13%), with a medium NRS of 8.1 (SD±1.82) pre-treatment and of 5.71 (SD±2.5) in the last 24 hours.
30 (9.1%) had taken the medication differently than prescribed. Signs of use disorder in 18 (5.4%), with the most reported withdrawal (n=8), addiction (n=6), and overdose (n=4); severe non‑therapeutic use disorder in 1 patient, the only one of the cohort with a history of heroin use disorder.
The risk of taking the medication differently than prescribed and developing signs of GBPs use disorder should be considered when prescribing these drugs.
Nevertheless, when administered within a specialized clinical setting, GBPs remain a valuable therapeutic option with a favourable safety and efficacy profile, and the likelihood of developing a severe use disorder appears to be confined to specific subgroups of patients.