Prescription rates for gabapentinoids are rising in England. Pregabalin is currently recommended by NICE for the treatment of anxiety. Gabapentinoids have some overlap with the action of benzodiazepines, and have similar issues with tolerance, dependence, addiction and withdrawal. They were scheduled as class C controlled drugs in 2019 because of these risks. There were 244 deaths due to poisoning recorded by the ONS in 2019 involving pregabalin. Poisonings due to pregabalin usually involve concomitant use of opioids or other drugs. The rate of deaths involving pregabalin has been rising steeply for the last 10 years, and now exceeds those attributed to diazepam, fentanyl, the tricyclics as a group or SSRIs as a group. Evidence for the use of pregabalin in anxiety is derived from short-term trials, with marginal differences from placebo, which do not take into account the longer term effects of tolerance, dependence and withdrawal. We call on NICE to re-evaluate their support for use of pregabalin in anxiety in light of its known harms. The use of gabapentinoids off-label for other psychiatric conditions should also be re-considered. In general, psychotropic medications require longer term efficacy and safety studies before allowing widespread use.

加巴喷丁胺类药物的处方率在英国正在上升。NICE目前推荐普瑞巴林用于治疗焦虑症。加巴喷丁胺类药物与苯二氮卓类药物的作用有些重叠，并且在耐受性，依赖性，成瘾性和戒断性方面也有类似的问题。由于这些风险，它们被安排在2019年被列为C类管制药物。ONS在2019年记录了244例因中毒而导致的死亡，其中涉及普瑞巴林。由于普瑞巴林造成的中毒通常涉及同时使用阿片类药物或其他药物。在过去的十年中，涉及普瑞巴林的死亡率急剧上升，现在已经超过地西epa，芬太尼，三环类或SSRI类。普瑞巴林用于焦虑症的证据来自短期试验，与安慰剂有轻微差异，没有考虑到宽容，依赖和退缩的长期影响。我们呼吁NICE根据已知危害，重新评估他们对普瑞巴林用于焦虑症的支持。还应考虑将加巴喷丁胺类药物用于其他精神疾病。通常，在广泛使用之前，精神药物需要长期的疗效和安全性研究。