ArticleBMJ (Clinical research ed.)2019
Associations between gabapentinoids and suicidal behaviour, unintentional overdoses, injuries, road traffic incidents, and violent crime: population based cohort study in Sweden.
Article in BMJ (Clinical research ed.), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
55 citing papers in PubMed, 4 syntheses or guidelines pooled it, 119 citations in OpenAlex.
- Optimising the Therapeutic Window: A Systematic Review and Network Meta-Analysis of Pregabalin Dosing Strategies for Painful Diabetic Neuropathy.Diabetes, obesity & metabolism · 2026Pooled it
- Gabapentin and pregabalin in bipolar disorder, anxiety states, and insomnia: Systematic review, meta-analysis, and rationale.Molecular psychiatry · 2022Pooled it
- Pooled it
- Neuropathic agents in the management of pruritus in burn injuries: a systematic review and meta-analysis.Trauma surgery & acute care open · 2021Pooled it
- Gabapentin as an adjunct to multimodal pain regimens in surgical patients: the GAP placebo-controlled RCT and economic evaluation.Health technology assessment (Winchester, England) · 2026Trial
- Reactive aldehyde species-mediated neuropathic pain in spinal cord injury: Mechanisms and therapeutic opportunities.Neural regeneration research · 2026Article
- Article
- Trigeminal neuralgia is associated with increased risk of cerebrovascular disease, myocardial infarction and suicide - a nationwide Swedish study.The journal of headache and pain · 2026Article
- A hospital-based multi-centric observational study to explore the prevalence and correlates of non-medical use and dependence of pregabalin among the patients with substance use disorder in Punjab & Chandigarh.Substance abuse treatment, prevention, and policy · 2026Observational
- Association between gabapentinoid treatment, concurrent use with opioid or benzodiazepine and the risk of drug poisoning: A self-controlled case series study.PLoS medicine · 2026Article
- Pregabalin dependence, withdrawal, suicidality and psychosis reports: A disproportionality analysis of the Australian adverse events database.British journal of clinical pharmacology · 2026Article
- Association Between Opioid Analgesics and Suicide Attempts: A Nationwide French Case-Crossover Study.CNS drugs · 2025Observational
- How Should Non-Prescribed Use of Gabapentinoids be Reduced in Psychiatric Practice?Human psychopharmacology · 2025Article
- Risks and Benefits of Pharmacological Treatment for Pediatric Chronic Non-cancer Pain: When Safety Evidence Lags Behind Prescription Pads.Paediatric drugs · 2025Review
- Trends in Drug Claims for Non-Specific Low Back Pain in Québec, 1997 to 2018.Musculoskeletal care · 2025Article
- Gabapentinoid Dispensing to Children and Adolescents in the U.S.American journal of preventive medicine · 2025Article
- Use of gabapentinoid treatment and the risk of self-harm: population based self-controlled case series study.BMJ (Clinical research ed.) · 2025Article
- Exploring Drug Use and Healthcare Utilization Among Adult Suicide Attempters: A Decision Tree Approach Using National Survey Data.Journal of nursing management · 2025Article
- Prescribing Patterns of Gabapentinoids in Chronic Pain Management: A Single Institution Retrospective Chart Review.Psychopharmacology bulletin · 2025Article
- Risk of Suicidal Ideation and Behavior Following Early-Onset Idiopathic Restless Legs Syndrome Treatment.Pharmacoepidemiology and drug safety · 2024Article
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 3 countries.
Funding
Abstract
objectiveTo examine associations between gabapentinoids and adverse outcomes related to coordination disturbances (head or body injuries, or both and road traffic incidents or offences), mental health (suicidal behaviour, unintentional overdoses), and criminality.
designPopulation based cohort study.
settingHigh quality prescription, patient, death, and crime registers, Sweden.
participants191 973 people from the Swedish Prescribed Drug Register who collected prescriptions for gabapentinoids (pregabalin or gabapentin) during 2006 to 2013.
main outcome measuresPrimary outcomes were suicidal behaviour, unintentional overdoses, head/body injuries, road traffic incidents and offences, and arrests for violent crime. Stratified Cox proportional hazards regression was conducted comparing treatment periods with non-treatment periods within an individual. Participants served as their own control, thus accounting for time invariant factors (eg, genetic and historical factors), and reducing confounding by indication. Additional adjustments were made by age, sex, comorbidities, substance use, and use of other antiepileptics.
resultsDuring the study period, 10 026 (5.2%) participants were treated for suicidal behaviour or died from suicide, 17 144 (8.9%) experienced an unintentional overdose, 12 070 (6.3%) had a road traffic incident or offence, 70 522 (36.7%) presented with head/body injuries, and 7984 (4.1%) were arrested for a violent crime. In within-individual analyses, gabapentinoid treatment was associated with increased hazards of suicidal behaviour and deaths from suicide (age adjusted hazard ratio 1.26, 95% confidence interval 1.20 to 1.32), unintentional overdoses (1.24, 1.19 to 1.28), head/body injuries (1.22, 1.19 to 1.25), and road traffic incidents and offences (1.13, 1.06 to 1.20). Associations with arrests for violent crime were less clear (1.04, 0.98 to 1.11). When the drugs were examined separately, pregabalin was associated with increased hazards of all outcomes, whereas gabapentin was associated with decreased or no statistically significant hazards. When stratifying on age, increased hazards of all outcomes were associated with participants aged 15 to 24 years.
conclusionsThis study suggests that gabapentinoids are associated with an increased risk of suicidal behaviour, unintentional overdoses, head/body injuries, and road traffic incidents and offences. Pregabalin was associated with higher hazards of these outcomes than gabapentin.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.