Gabapentinoids – gabapentin and pregabalin – were traditionally prescribed for their approved indications: the treatment of seizures and various manifestations of neuropathic pain. Of course, there are many newer agents for epilepsy, and the the market for neuropathic pain ought to remain fairly stable. Therefore, why has gabapentinoid use effectively tripled over the past decade, as generally described by this research letter?
Most notably, in this letter, gapapentin use increased most in those with multiple comorbidities, as well as those with concurrent opioid and benzodiazepine prescriptions. Considering the lack of proven efficacy and the potential for misuse or adverse effects, there’s frankly no excuse for such rampant overuse. Nearly all this expansion represents waste and harm in our health system, with mixed and scattershot evaluation of its various applications almost certain to mislead rather than inform true treatment effects.
It seems it really ought to be time to reduce prescribing of gabapentinoids – particularly off-label – but the reverse seems true!
“Gabapentinoid Use in the United States 2002 Through 2015”
https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2666788
It must be due to the fact that Lyrica is still on patent until July 2019.
My guess is it will then get black boxed and a new sterio-isomer of a gabapentinoid will become all the rage.
There are so many negative trials evaluating gabapentin for some sort of off-label use, it’s staggering.
I can only hope there’s nothing coming next, and without someone pushing Lyrica, all this misuse will gradually decline.