title: Abuse Potential of Pregabalin: A Systematic Review.
abstract: BACKGROUND
  Several case reports and epidemiological studies have raised concern about the abuse potential of pregabalin, the use of which has increased substantially over the last decade. Pregabalin is, in some cases, used for recreational purposes and it has incurred attention among drug abusers for causing euphoric and dissociative effects when taken in doses exceeding normal therapeutic dosages or used by alternative routes of administration, such as nasal insufflation or venous injection. The magnitude of the abuse potential and the mechanism behind it are not fully known.
  
  
  OBJECTIVE
  The aim of this study was to present a systematic review of the data concerning the abuse potential of pregabalin.
  
  
  METHODS
  We performed a systematic literature search and reviewed the preclinical, clinical and epidemiological data on the abuse potential of pregabalin.
  
  
  RESULTS
  We included preclinical (n = 17), clinical (n = 19) and epidemiological (n = 13) studies addressing the abuse potential of pregabalin. We also reviewed case reports (n = 9) concerning abuse of pregabalin. The preclinical studies indicated that pregabalin possesses modulatory effects on the GABA and glutamate systems, leaving room for an abuse potential. Further, clinical studies reported euphoria as a frequent side effect in patients treated with pregabalin. The majority of case reports concerning abuse of pregabalin involved patients with a history of substance abuse and, similarly, epidemiological studies found evidence of abuse, especially among opiate abusers.
  
  
  CONCLUSIONS
  Overall, the available literature suggests an important clinical abuse potential of pregabalin and prescribers should pay attention to signs of abuse, especially in patients with a history of substance abuse.
authors.affiliation: Department of Psychiatry, Aalborg University Hospital, Aalborg, Denmark. o.schjerning@rn.dk.|Department of Clinical Medicine, Aalborg University, Aalborg, Denmark. o.schjerning@rn.dk.|Centre for Schizophrenia, Brandevej 5, 9220, Aalborg, Denmark. o.schjerning@rn.dk.
authors.forename: Ole
authors.identifier: http://orcid.org/0000-0003-1764-0912
authors.initials: O
authors.lastname: Schjerning
authors.affiliation: Danish Health and Medicines Authority, Copenhagen, Denmark.
authors.forename: Mary
authors.initials: M
authors.lastname: Rosenzweig
authors.affiliation: Clinical Pharmacology, Department of Public Health, University of Southern Denmark, Odense, Denmark.
authors.forename: Anton
authors.initials: A
authors.lastname: Pottegård
authors.affiliation: Clinical Pharmacology, Department of Public Health, University of Southern Denmark, Odense, Denmark.|Department of Clinical Chemistry and Pharmacology, Odense University Hospital, Odense, Denmark.
authors.forename: Per
authors.initials: P
authors.lastname: Damkier
authors.affiliation: Department of Psychiatry, Aalborg University Hospital, Aalborg, Denmark.|Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
authors.forename: Jimmi
authors.initials: J
authors.lastname: Nielsen
mesh_terms: D000818:Animals; D002986:Clinical Trials as Topic; D004353:Drug Evaluation, Preclinical; D005059:Euphoria / Q000187:drug effects; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects*; D000069583:Pregabalin / Q000009:adverse effects*; D063487:Prescription Drug Misuse / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000209:etiology
chemical_list: D013287:Illicit Drugs; D000069583:Pregabalin