Pregabalin use in forensic hospitals and prisons in German speaking countries—a survey study of physicians
BackgroundPregabalin is a gamma-aminobutyric acid (GABA) analog that was approved in the EU in 2004 for the treatment of neuropathic pain, generalized anxiety disorder and epilepsy. Since its introduction, pregabalin abuse and misuse has increased significantly. In Switzerland, clinical reports sugg...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-01-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1309654/full |
| _version_ | 1797362556349710336 |
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| author | Michal Novotny Michal Novotny Jan Bulla Daniela Hubl Sebastian Karl Maximilian Fischer Martin Grosshans Andreas Gutzeit Andreas Gutzeit Andreas Gutzeit Oliver Bilke-Hentsch Erich Seifritz Jochen Mutschler |
| author_facet | Michal Novotny Michal Novotny Jan Bulla Daniela Hubl Sebastian Karl Maximilian Fischer Martin Grosshans Andreas Gutzeit Andreas Gutzeit Andreas Gutzeit Oliver Bilke-Hentsch Erich Seifritz Jochen Mutschler |
| author_sort | Michal Novotny |
| collection | DOAJ |
| description | BackgroundPregabalin is a gamma-aminobutyric acid (GABA) analog that was approved in the EU in 2004 for the treatment of neuropathic pain, generalized anxiety disorder and epilepsy. Since its introduction, pregabalin abuse and misuse has increased significantly. In Switzerland, clinical reports suggest that pregabalin misuse is common among patients in forensic hospitals and prisons. However, data on pregabalin use is scarce, especially in these settings. Therefore, we conducted a study to explore patterns of pregabalin use among prison and forensic patients.MethodsWe used a questionnaire to survey physicians working in prison and forensic medicine in German-speaking countries. A total of 131 responses were received.ResultsAccording to the physicians' subjective assessment, 82.5% of them had observed a recent increase in pregabalin use by their patients and 89.1% of them reported that their patients requested pregabalin without a clear medical indication. Patients misusing pregabalin in combination with other illicit substances were observed by 93.3% of the physicians surveyed. According to 73.5% of the physicians surveyed, they had already encountered patients on pregabalin doses of more than 600 mg/day (the maximum recommended daily dose); the highest dose reported was 4,200 mg/day. According to 85.0% of physicians surveyed, they have observed patients experiencing withdrawal symptoms from pregabalin, with the most commonly reported symptoms being displeasure and high aggression. Regarding the nationality of pregabalin-misusing patients, 58.3% of the interviewed physicians reported to be rather in contact with foreign patients, mainly from Northwest Africa (Maghreb). Only 45.0% of the surveyed physicians prescribe pregabalin. Among patients who developed behavioral problems while taking pregabalin, none of the physicians (0.0%) showed a tendency to continue pregabalin at the same dose; all respondents chose to reduce/substitute/discontinue.ConclusionOur study has provided confirmatory evidence that the use of pregabalin presents a significant issue in forensic and prison medicine across German-speaking countries. Prescribing pregabalin in this field can compound use disorder problems and exacerbate challenges in daily life for those in forensic institutions or prisons. It is necessary that all physicians who prescribe pregabalin are clearly informed about the management (including the risks) of this drug. |
| first_indexed | 2024-03-08T16:09:39Z |
| format | Article |
| id | doaj.art-a26f53d231c0402b8f77979f978d607d |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-03-08T16:09:39Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-a26f53d231c0402b8f77979f978d607d2024-01-08T04:18:56ZengFrontiers Media S.A.Frontiers in Public Health2296-25652024-01-011110.3389/fpubh.2023.13096541309654Pregabalin use in forensic hospitals and prisons in German speaking countries—a survey study of physiciansMichal Novotny0Michal Novotny1Jan Bulla2Daniela Hubl3Sebastian Karl Maximilian Fischer4Martin Grosshans5Andreas Gutzeit6Andreas Gutzeit7Andreas Gutzeit8Oliver Bilke-Hentsch9Erich Seifritz10Jochen Mutschler11Private Clinic Meiringen, Willigen, SwitzerlandFaculty of Medicine, University of Zurich, Zurich, SwitzerlandClinic of Forensic Psychiatry and Psychotherapy, Reichenau Centre of Psychiatry, Reichenau, GermanyCenter of Forensic Psychiatry and Psychology, Universitäre Psychiatrische Dienste Bern (UPD), Bern, SwitzerlandPsychiatric Services Lucerne, Lucerne, SwitzerlandDepartment of Global Health, Safety and Well-Being, Systemanalyse Programmentwicklung Societas Europaea (SAP SE), Walldorf, GermanyDepartment of Radiology, Paracelsus Medical University, Salzburg, AustriaDepartment of Health Sciences and Medicine, University of Lucerne, Lucerne, SwitzerlandInstitute of Radiology and Nuclear Medicine and Breast Center St. Anna, Hirslanden Klinik St. Anna, Lucerne, SwitzerlandPsychiatric Services Lucerne, Lucerne, Switzerland0Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, SwitzerlandPsychiatric Services Lucerne, Lucerne, SwitzerlandBackgroundPregabalin is a gamma-aminobutyric acid (GABA) analog that was approved in the EU in 2004 for the treatment of neuropathic pain, generalized anxiety disorder and epilepsy. Since its introduction, pregabalin abuse and misuse has increased significantly. In Switzerland, clinical reports suggest that pregabalin misuse is common among patients in forensic hospitals and prisons. However, data on pregabalin use is scarce, especially in these settings. Therefore, we conducted a study to explore patterns of pregabalin use among prison and forensic patients.MethodsWe used a questionnaire to survey physicians working in prison and forensic medicine in German-speaking countries. A total of 131 responses were received.ResultsAccording to the physicians' subjective assessment, 82.5% of them had observed a recent increase in pregabalin use by their patients and 89.1% of them reported that their patients requested pregabalin without a clear medical indication. Patients misusing pregabalin in combination with other illicit substances were observed by 93.3% of the physicians surveyed. According to 73.5% of the physicians surveyed, they had already encountered patients on pregabalin doses of more than 600 mg/day (the maximum recommended daily dose); the highest dose reported was 4,200 mg/day. According to 85.0% of physicians surveyed, they have observed patients experiencing withdrawal symptoms from pregabalin, with the most commonly reported symptoms being displeasure and high aggression. Regarding the nationality of pregabalin-misusing patients, 58.3% of the interviewed physicians reported to be rather in contact with foreign patients, mainly from Northwest Africa (Maghreb). Only 45.0% of the surveyed physicians prescribe pregabalin. Among patients who developed behavioral problems while taking pregabalin, none of the physicians (0.0%) showed a tendency to continue pregabalin at the same dose; all respondents chose to reduce/substitute/discontinue.ConclusionOur study has provided confirmatory evidence that the use of pregabalin presents a significant issue in forensic and prison medicine across German-speaking countries. Prescribing pregabalin in this field can compound use disorder problems and exacerbate challenges in daily life for those in forensic institutions or prisons. It is necessary that all physicians who prescribe pregabalin are clearly informed about the management (including the risks) of this drug.https://www.frontiersin.org/articles/10.3389/fpubh.2023.1309654/fullpregabalinmisuseprisonforensicpharmacologyGerman-speaking countries |
| spellingShingle | Michal Novotny Michal Novotny Jan Bulla Daniela Hubl Sebastian Karl Maximilian Fischer Martin Grosshans Andreas Gutzeit Andreas Gutzeit Andreas Gutzeit Oliver Bilke-Hentsch Erich Seifritz Jochen Mutschler Pregabalin use in forensic hospitals and prisons in German speaking countries—a survey study of physicians Frontiers in Public Health pregabalin misuse prison forensic pharmacology German-speaking countries |
| title | Pregabalin use in forensic hospitals and prisons in German speaking countries—a survey study of physicians |
| title_full | Pregabalin use in forensic hospitals and prisons in German speaking countries—a survey study of physicians |
| title_fullStr | Pregabalin use in forensic hospitals and prisons in German speaking countries—a survey study of physicians |
| title_full_unstemmed | Pregabalin use in forensic hospitals and prisons in German speaking countries—a survey study of physicians |
| title_short | Pregabalin use in forensic hospitals and prisons in German speaking countries—a survey study of physicians |
| title_sort | pregabalin use in forensic hospitals and prisons in german speaking countries a survey study of physicians |
| topic | pregabalin misuse prison forensic pharmacology German-speaking countries |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1309654/full |
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