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Pregabalin abuse for enhancing sexual performance: case discussion and literature review

Published online by Cambridge University Press:  27 August 2014

M. Osman  and
P. Casey
M. Osman*
Affiliation:
Mater Misericordiae University Hospital, University College Dublin, Dublin, Ireland
*
*Address for correspondence: M. Osman, Department of Adult Psychiatry, Mater Misericordae University Hospital and University College Dublin, 63 Eccles Street, Dublin 7, Ireland. (Email: mugtabasulman@yahoo.co.uk)
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Abstract

Pregabalin is a γ-aminobutyric acid analogue that is primarily prescribed in psychiatry for management of generalized anxiety disorder. The belief in its low potential for abuse has placed it in a superior position to other anxiolytic agents. However, more recent, concerns have been raised about the addictive potential of pregabalin. This problem has not received much attention nor has the mechanism of its development. There is also a lack of understanding of the difference in the experience of abusing pregabalin in contrast to abusing other illicit drugs. We report the case of a 55-year-old patient with a background history of multiple psychoactive substances misuse who elaborated on his own personal experience of pregabalin abuse. He consumed a month’s supply of this medication over 2 days and realized an enhancement in sexual desire and excitement. This effect should be considered when prescribing pregabalin.

Keywords

Pregabalinpsychological sexual dysfunctionssexual behavioursubstance abuse detectionsubstance-related disorders
Type
Case Report
Information
Irish Journal of Psychological Medicine , Volume 31 , Issue 4 , December 2014 , pp. 281 - 286
Copyright
© College of Psychiatrists of Ireland 2014 

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References

Aksaka, E, Emet, M (2012). Complete atrioventricular block due to overdose of pregabalin. American Journal of Emergency Medicine 30, 2101.e1–2101.e4.Google Scholar
Allgulander, C (2010). Novel approaches to treatment of generalized anxiety disorder. Current Opinion in Psychiatry 23, 37–42.CrossRefGoogle ScholarPubMed
Baldwin, DS, Ajel, K (2007). Role of pregabalin in the treatment of generalized anxiety disorder. Neuropsychiatric Disease and Treatment 3, 185–191.Google Scholar
BCAP (2012). Prescribing and Therapeutics Shared Care Guidelines for Pregabalin for Refractory Neuropathic Pain (http://www.bathdiabetes.org/resources/268.pdf). Accessed 11 December 2012.Google Scholar
Ben-Menachem, E (2004). Pregabalin pharmacology and its relevance to clinical practice. Epilepsia 45 (Suppl. 6): 13–18.CrossRefGoogle ScholarPubMed
Berry, D, Millington, C (2005). Analysis of pregabalin at therapeutic concentrations in human plasma/serum by reversed-phase HPLC. Therapeutic Drug Monitoring 27, 451–456.Google Scholar
Boyle, J, Eriksson, ME, Gribble, L, Gouni, R, Johnsen, S, Coppini, DV, Kerr, D (2012). Randomized, placebo-controlled comparison of amitriptyline, duloxetine, and pregabalin in patients with chronic diabetic peripheral neuropathic pain: impact on pain, polysomnographic sleep, daytime functioning, and quality of life. Diabetes Care 35, 2451–2458.CrossRefGoogle ScholarPubMed
Bucur, M, Jeczmien, P (2011). Pregabalin and libido-case reports. The Open Neuropsychopharmacology Journal 4, 8–9.CrossRefGoogle Scholar
Canadian Agency for Drugs and Technologies in Health (CADTH) (2012). Rapid response report, summary with critical appraisal, abuse and misuse potential for pregabalin; a review of the clinical evidence, 24 April 2012 (http://dpic.org/sites/default/files/PregabalinAbuse_CADTH_24Apr2012.pdf). Accessed 11 December 2012.Google Scholar
Chen, ZR, Irvine, RJ, Somogyi, AA, Bochner, F (1991). Mu receptor binding of some commonly used opioids and their metabolites. Life Sciences 48, 2165–2171.Google Scholar
Dijkstra, BA, Krabbe, PF, De Jong, CA, van der Staak, CP (2008). Prediction of withdrawal symptoms during opioid detoxification. Journal of Opioid Management 4, 311–319.Google Scholar
Dobrea, C, Buoli, M, Arici, C, Camuri, G, Dell’osso, B, Altamura, AC (2012). Tolerability and use in co-administration of pregabalin in affective patients: a 6-month prospective naturalistic study. Expert Opinion on Drug Safety 11, 893–899.Google Scholar
El-Bassel, N, Gilbert, L, Rajah, V (2003). The relationship between drug abuse and sexual performance among women on methadone heightening the risk of sexual intimate violence and HIV. Addictive Behaviors 28, 1385–1403.Google Scholar
European Medicines Agency (2006). Lyrica – scientific discussion, European Medicines Agency, London.Google Scholar
European Monitoring Centre for Drugs and Drug Addiction (2012). Gabapentin and pregabalin: abuse and addiction. Prescrire International 21, 152–154.Google Scholar
Feltner, DE, Crockatt, JG, Dubovsky, SJ, Cohn, CK, Shrivastava, RK, Targum, SD, Liu-Dumaw, M, Carter, CM, Pande, AC (2003). A randomized, double-blind, placebo-controlled, fixed-dose, multicenter study of pregabalin in patients with generalized anxiety disorder. Journal of Clinical Psychopharmacology 23, 240–249.CrossRefGoogle ScholarPubMed
Filipetto, FA, Zipp, CP, Coren, JS (2010). Potential for pregabalin abuse or diversion after past drug-seeking behaviour. The Journal of the American Osteopathic Association 110, 605–607.Google ScholarPubMed
Frame, B, Miller, R, Hutmacher, MM (2009). Joint modeling of dizziness, drowsiness, and dropout associated with pregabalin and placebo treatment of generalized anxiety disorder. Journal of Pharmacokinetics and Pharmacodynamics 36, 565–584.CrossRefGoogle ScholarPubMed
Graversen, C, Olesen, SS, Olesen, AE, Steimle, K, Farina, D, Wilder-Smith, OH, Bouwense, SA, van Goor, H (2012). The analgesic effect of pregabalin in patients with chronic pain is reflected by changes in pharmaco-EEG spectral indices. British Journal of Clinical Pharmacology 73, 363–372.Google Scholar
Grosshans, M, Mutschler, J, Hermann, D, Klein, O, Dressing, H, Kiefer, F, Mann, K (2010). Pregabalin abuse, dependence, and withdrawal: a case report. American Journal of Psychiatry 167, 869.CrossRefGoogle ScholarPubMed
Health and Social Board Headquarters in Belfast (2012). Office of Assistant Director of Integrated Care–Pharmacy & Medicines Management: Misuse and Diversion Potential of Pregabalin (Lyrica), 6 November (http://www.hscboard.hscni.net/medicinesmanagement/Correspondence/082%20November%202012%20-%20Letter%20-%20Pregabalin%20Misuse%20-%20PDF%2060KB.pdf).Accessed 12 December 2012.Google Scholar
Hill, DR, Suman-Chauhan, N, Woodruff, GN (1993). Localization of [3 H]gabapentin to a novel site in rat brain: autoradiographic studies. European Journal of Pharmacology 244, 303–309.CrossRefGoogle ScholarPubMed
Hitiris, N, Barrett, JA, Brodie, MJ (2006). Erectile dysfunction associated with pregabalin add-on treatment in patients with partial seizures: five case reports. Epilepsy and Behavior 8, 418–421.Google Scholar
ICD 10 Online (2010). WHO: Geneva. (http://apps.who.433 int/classifications/icd10/browse/2010/en#/F40-F48) Accessed on 28 November 2012.Google Scholar
Kamel, JT, D’Souza, WJ, Cook, MJ (2010). Severe and disabling constipation: an adverse effect of pregabalin. Epilepsia 51, 1094–1096.CrossRefGoogle ScholarPubMed
Kapczinski, F, Lima, MS, Souza, JS, Schmitt, R (2003). Antidepressants for generalized anxiety disorder. Cochrane Database of Systematic Reviews 2003, CD003592.Google Scholar
Kavoussi, R (2006). Pregabalin: from molecule to medicine. European Neuropsychopharmacology 16 (Suppl. 2): S128–S133.Google Scholar
Leonhart, M (2005). Schedules of Controlled Substances: Placement of Pregabalin Into Schedule V. Federal Register 70, 43633–43635.Google Scholar
Lenox-Smith, AJ, Reynolds, A (2003). A double-blind, randomised, placebo controlled study of venlafaxine XL in patients with generalised anxiety disorder in primary care. The British Journal of General Practice 53, 772–777.Google Scholar
Li, Z, Taylor, CP, Weber, M, Piechan, J, Prior, F, Bian, F, Cui, M, Hoffman, D, Donevan, S (2011). Pregabalin is a potent and selective ligand for α(2)δ-1 and α(2)δ-2 calcium channel subunits. European Journal of Pharmacology 667, 80–90.Google Scholar
Miljevic, C, Crnobaric, C, Nikolic, S, Lecic-Tosevski, D (2012). A case of pregabalin intoxication. Psychiatriki 23, 162–165.Google Scholar
Montgomery, SA, Tobias, K, Zornberg, GL, Kasper, S, Pande, AC (2006). Efficacy and treatment of generalized anxiety disorder: a 6-week, multicenter, randomized, double-blind, placebo-controlled comparison of pregabalin and venlafaxine. Journal of Clinical Psychiatry 67, 771–782.CrossRefGoogle ScholarPubMed
National Institute for Health and Clinical Excellence (2007). Anxiety (amended). Management of anxiety (panic disorder, with or without agoraphobia, and generalised anxiety disorder) in adults in primary, secondary and community care. Clinical Guidance 22, April (http://www.nice.org.uk).Google Scholar
Olaizola, I, Ellger, T, Young, P, Bösebeck, F, Evers, S, Kellinghaus, C (2006). Pregabalin-associated acute psychosis and epileptiform EEG-changes. Seizure: The Journal of the British Epilepsy Association 15, 208–210.CrossRefGoogle ScholarPubMed
Oulis, P, Konstantakopoulos, G, Kouzoupis, AV, Masdrakis, VG, Karakatsanis, NA, Karapoulios, E, Kontoangelos, KA, Papadimitriou, GN (2008 a). Pregabalin in the discontinuation of long-term benzodiazepines’ use. Human Psychopharmacology 23, 337–340.Google Scholar
Oulis, P, Kouzoupis, AV, Koulouris, G, Masdrakis, VG, Kontoangelos, K, Matsoukas, T, Papadimitriou, GN (2008 b). Acute pregabalin reversal of citalopram-induced sexual dysfunction in generalized anxiety disorder. Journal of Clinical Psychopharmacology 28, 362–363.Google Scholar
Page, RL 2nd, Cantu, M, Lindenfeld, J, Hergott, LJ, Lowes, BD (2008). Possible heart failure exacerbation associated with pregabalin: case discussion and literature review. Journal of Cardiovascular Medicine 9, 922–925.Google Scholar
Pande, A, Crockatt, J, Feltner, D, Janney, C, Smith, W, Weisler, R, Londborg, P, Bielski, R, Zimbroff, D, Davidson, J, Liu-Dumaw, M (2003). Pregabalin in generalized anxiety disorder: a placebo-controlled trial. American Journal of Psychiatry 160, 533–540.Google Scholar
Philippsohn, S, Kruger, TH (2012). Persistent genital arousal disorder: successful treatment with duloxetine and pregabalin in two cases. The Journal of Sexual Medicine 9, 213–217.Google Scholar
Pohl, RB, Feltner, DE, Fieve, RR, Pande, AC (2005). Efficacy of pregabalin in the treatment of generalized anxiety disorder: double-blind, placebo-controlled comparison of BID versus TID dosing. Journal of Clinical Psychopharmacology 25, 151–158.Google Scholar
Reedy, SJD, Schwartz, MD (2010). A case series of recreational pregabalin overdose resulting in generalized seizures. Clinical Toxicology 48, 616–617.Google Scholar
Rickels, K, Zaninelli, R, McCafferty, J, Bellew, K, Iyengar, M, Sheehan, D (2003). Paroxetine treatment of generalized anxiety disorder: a double-blind, placebo-controlled study. American Journal of Psychiatry 160, 749–756.Google Scholar
Saddock, VA (2005). Normal human sexuality and sexual dysfunctions. In Kaplan and Sadock’s Comprehensive Textbook of Psychiatry (ed. VA Sadock and BJ Sadock), 8th edn. vol. 1, p. 1902. Baltimore, Lippincott Williams and Wilkins: New York.Google Scholar
Schifano, F, D’Offizi, S, Piccione, M, Corazza, O, Deluca, P, Davey, Z, Di Melchiorre, G, Di Furia, L, Farré, M, Flesland, L, Mannonen, M, Majava, A, Pagani, S, Peltoniemi, T, Siemann, H, Skutle, A, Torrens, M, Pezzolesi, C, van der Kreeft, P, Scherbaum, N (2011). Is there a recreational misuse potential for pregabalin? Analysis of anecdotal online reports in comparison with related gabapentin and clonazepam data. Psychotherapy and Psychosomatics 80, 118–122.Google Scholar
Schwan, S, Sundström, A, Stjernberg, E, Hallberg, E, Hallberg, P (2010). A signal for an abuse liability for pregabalin – results from the Swedish spontaneous adverse drug reaction reporting system. European Journal of Clinical Pharmacology 66, 947–953.Google Scholar
Selak, I (2001). Pregabalin (Pfizer). Current Opinion in Investigational Drugs 2, 828–834.Google ScholarPubMed
Skopp, G, Zimmer, G (2012). Pregabalin – a drug with abuse potential? Archiv für Kriminologie 229, 44–54.Google ScholarPubMed
Spiller, HA, Bratcher, R, Griffith, JR (2008). Pregabalin overdose with benign outcome. Clinical Toxicology (Philadilphia) 46, 917.CrossRefGoogle ScholarPubMed
Taylor, D, Paton, C, Kapur, S (2009). The Maudsley Prescribing Guidelines, 10th edn. Informa Healthcare: London, pp. 457–461.CrossRefGoogle Scholar
Yargic, I, Ozdemiroglu, FA (2011). Pregabalin abuse: a case report. Bulletin of Clinical Psychopharmachology 21, 64–66.Google Scholar
Zaccara, G, Gangemi, P, Perucca, P, Specchio, L (2011). The adverse event profile of pregabalin: a systematic review and meta-analysis of randomized controlled trials. Epilepsia 52, 826–836.Google Scholar
Zacny, JP, Paice, JA, Coalson, DW (2012). Subjective, psychomotor, and physiological effects of pregabalin alone and in combination with oxycodone in healthy volunteers. Pharmacology. Biochemistry and Behavior 100, 560–565.Google Scholar
Zhou, Q, Zheng, J, Yu, L, Jia, X (2012). Pregabalin monotherapy for epilepsy. Cochrane Database of Systematic Reviews 17, CD009429.Google Scholar