(Reuters Health) – – Prescriptions for nerve ache medicines like Neurontin and Lyrica have greater than tripled in recent times, pushed by elevated use amongst chronically ailing older adults and sufferers already taking opioids, a U.S. research suggests.
The proportion of U.S. adults prescribed Neurontin and different medicine in the identical household of medicines climbed from 1.2 p.c in 2002 to three.9 p.c by 2015, a interval that additionally noticed a surge in opioid overdoses and deaths. The household of medicines, referred to as gabapentinoids, contains gabapentin (Neurontin, Gralise, Horizant) and pregabalin.
“Nearly one in 25 adults takes a gabapentinoid during a year, which matters because we have little data to support much use of this drug class and minimal data to support the long-term safety of the medications,” mentioned research writer Dr. Michael Johansen of the Heritage College of Osteopathic Medicine at Ohio University in Athens.
“My suspicion is that much of the use is driven by attempting to treat chronic pain with a non-opioid medication,” Johansen mentioned by e-mail.
U.S. deaths from opioids together with heroin and prescribed drugs like oxycodone, hydrocodone and methadone have greater than quadrupled since 1999, in line with the Centers for Disease Control and Prevention in Atlanta. Today, greater than six in 10 drug overdose deaths contain opioids.
Amid this worsening opioid epidemic, the CDC has urged physicians to prescribe different medicine for ache together with acetaminophen and nonsteroidal anti-inflammatory medicine (NSAIDs) in addition to gabapentinoids.
Gabapentin and pregabalin each have received U.S. Food and Drug Administration (FDA) approval for treating partial seizures and a kind of nerve ache brought on by shingles. A model of gabapentin has additionally been authorised for stressed leg syndrome, and pregabalin has extra approvals for fibromyalgia and nerve ache associated to diabetes and spinal wire accidents.
While the FDA doesn’t permit drug firms to advertise these medicines for different situations, docs are free to prescribe the medicine for off-label, or unapproved, makes use of.
Off-label use of gabapentinoids has been controversial, nonetheless, as a result of these medicine will be addictive, they haven’t been confirmed efficient for a lot of frequent unapproved makes use of and there’s restricted long-term security information, Johansen writes in JAMA Internal Medicine.
For his research, Johansen reviewed survey information from a nationally consultant pattern of 346,177 adults, together with particulars on any medical situations and prescriptions.
Overall, greater than 4 out of 5 of prescriptions for gabapentinoids had been for gabapentin, the evaluation discovered.
Prescription development was concentrated amongst older adults, diabetics, individuals with a number of continual well being issues and sufferers already taking opioids or benzodiazepines like Valium and Xanax.
One limitation of the research is that it relied on members to precisely report on any drug use, and it’s attainable that some individuals didn’t disclose opioid use. The research didn’t embody prescription information or info on drug prices.
“The use of gabapentinoids specifically seems to be outpacing any proven efficacy and the potential significant harms like addiction and overdose are only beginning to be investigated,” mentioned Dr. Christopher Goodman, a researcher on the University of South Carolina School of Medicine in Columbia who wasn’t concerned within the research.
While some sufferers could profit from these medicine, they need to think about different approaches to ache administration like train, bodily remedy and yoga that could be safer and nonetheless present some reduction, Goodman mentioned by e-mail.
Side results of gabapentinoids embody sedation, dizziness and hassle pondering, Dr. Chad Brummett, an opioid researcher on the University of Michigan in Ann Arbor who wasn’t concerned within the research, mentioned by e-mail. The dangers are worse at greater doses.
Mixing these medicine with opioids and benzodiazapines could make them much more harmful, mentioned Marissa Seamans, a researcher on the Johns Hopkins Bloomberg School of Public Health in Baltimore who wasn’t concerned within the research.
“Gabapentinoids are increasingly prescribed to patients with opioids and benzodiazapines, which increases the risk of respiratory depression and death,” Seamans mentioned by e-mail. “Clinicians and patients need to carefully monitor the dosage of these medicines, their interactions, and potentially fatal side effects.”
SOURCE: bit.ly/2Ar8g2m JAMA Internal Medicine, on-line January 2, 2018.