Australian pregabalin use and overdoses decline following new restrictions

Researchers found that the use and overdose rates of pregabalin, a drug used to treat epilepsy and nerve pain, have fallen in Australia since 2018.

The study, published in The BMJ, analyzed dispensing claims and poison center data from 2016 to 2024 to track these trends. The data showed that pregabalin use peaked in 2018 and then began to decrease.

Researchers identified three specific periods of significant decline: December 2018 following intense media coverage on drug harms, May 2020 after authorities introduced tighter prescribing rules, and December 2021 after the government added boxed warnings and a real-time prescription monitoring system. The results show that prescriptions were 25% lower than expected based on historical trends, while intentional poisoning calls dropped by 47% compared to projections.

While the researchers cannot prove these measures directly caused the decline, they suggest the findings could help other countries manage similar issues with gabapentinoids. Despite the downward trend, the researchers noted that usage remains higher than what would be expected for approved medical uses alone. They called for continued monitoring and further restrictions. Professor David Juurlink warned that doctors should reserve the drug for specific conditions like diabetic nerve pain rather than using it as a general painkiller.