Drug Abuse: Gabapentinoids
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Questions and Answers

What is the class of prescribed agents that have a high risk for misuse, abuse, and dependency?

  • Gabapentinoids (correct)
  • Anticonvulsants
  • Opioids
  • Benzodiazepines
  • What is the primary mechanism of action of pregabalin?

  • Binding to benzodiazepine receptors
  • Binding to and blocking α2-δ subunit of voltage-gated calcium channels (correct)
  • Binding to GABA receptors
  • Inhibiting the release of glutamate
  • What is the main difference between pregabalin and gabapentin?

  • Pregabalin is more effective in treating epilepsy
  • Gabapentin is more effective in treating anxiety disorders
  • Pregabalin has a faster onset of action
  • Pregabalin is 6 times more potent than gabapentin (correct)
  • What is a common off-label use of gabapentinoids?

    <p>Treatment of bipolar disorder</p> Signup and view all the answers

    What is the total sales of pregabalin worldwide in 2013?

    <p>5 billion dollars</p> Signup and view all the answers

    What is the effect of pregabalin on excitatory neurotransmitters?

    <p>It decreases the release of glutamate</p> Signup and view all the answers

    What is the effect of gabapentin administration on GABA concentration?

    <p>50% increase</p> Signup and view all the answers

    Why does pregabalin produce an euphoric effect?

    <p>The exact mechanism is not fully known</p> Signup and view all the answers

    What is a psychotropic effect of pregabalin?

    <p>Euphoria</p> Signup and view all the answers

    What is a side effect of pregabalin overdose?

    <p>Suicidal ideation</p> Signup and view all the answers

    What is a withdrawal symptom of pregabalin?

    <p>Anxiety</p> Signup and view all the answers

    How should pregabalin dependence be treated?

    <p>Tapering off by 50-100 mg/week</p> Signup and view all the answers

    Study Notes

    Gabapentinoids

    • Gabapentinoids (pregabalin and gabapentin) are a class of prescribed agents with a high risk for misuse, abuse, and dependency.
    • They are used to treat epilepsy, neuropathic pains, generalized anxiety disorder, and fibromyalgia.
    • Off-label uses include treatment of bipolar disorder, alcoholic/narcotic withdrawal state, ADHD, and migraine.

    Pregabalin

    • Pregabalin is an analog of γ-aminobutyric acid (GABA) but does not bind directly to GABA or benzodiazepine receptors.
    • Total sales of pregabalin worldwide reached $5 billion in 2013.
    • Pregabalin is 6 times more potent than gabapentin and has higher binding affinity at their receptors.
    • Oral pregabalin has rapid absorption and higher bioavailability.

    Pharmacology of Pregabalin

    • Pregabalin binds to and blocks α2-δ subunit of voltage-gated calcium channels on neurons, decreasing excitatory neurotransmitters (e.g., glutamate, noradrenaline, and substance P).
    • Pregabalin has GABA-mimetic activity, inhibiting GABA metabolism and altering neuronal GABA transporters.
    • Gabapentin administration increases GABA concentration by about 50%.

    Psychotropic Effects of Pregabalin

    • Pregabalin is considered an ideal psychotropic drug for recreational purposes, producing sedation, euphoria, improved sociability, marijuana-like high/relaxant effect, opioid-like sedative effects, and dissociative/psychedelic effects.

    Pregabalin Overdose and Withdrawal

    • High doses of pregabalin cause sedation, suicidal ideation, dizziness and somnolence, impaired driving, respiratory depression, and death.
    • Withdrawal symptoms include anxiety, depression, agitation, nausea, palpitations, insomnia, hyperhidrosis, and diarrhea.

    Pregabalin in Addiction Treatment

    • Pregabalin has beneficial effects in managing addiction to various drugs, including alcohol, benzodiazepines, opioids, and cannabis.
    • Treatment of pregabalin dependence involves discontinuation by tapering the dose and administration of CNS depressants to control withdrawal symptoms.

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    Description

    This quiz covers the misuse, abuse, and dependency of gabapentinoids, a class of prescribed agents used to treat various conditions including epilepsy, neuropathic pains, and anxiety disorder.

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