Evidence map›Paper›PMID 40306941›Full record

ArticleBMJ (Clinical research ed.)2025

Use of gabapentinoid treatment and the risk of self-harm: population based self-controlled case series study.

Andrew S C Yuen, Boqing Chen, Adrienne Y L Chan, Joseph F Hayes, David P J Osborn, Frank M C Besag, Wallis C Y Lau, Ian C K Wong, Li Wei, Kenneth K C Man

Erratum issuedAbstract read
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In one paragraph

Article in BMJ (Clinical research ed.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Andrew S C YuenResearch Department of Practice and Policy, School of Pharmacy, University College London, London, UK.
Boqing ChenResearch Department of Practice and Policy, School of Pharmacy, University College London, London, UK.
Adrienne Y L ChanSchool of Pharmacy, Aston University, Birmingham, UK.
Joseph F HayesDivision of Psychiatry, University College London, London, UK.
David P J OsbornDivision of Psychiatry, University College London, London, UK.
Frank M C BesagResearch Department of Practice and Policy, School of Pharmacy, University College London, London, UK.
Wallis C Y LauResearch Department of Practice and Policy, School of Pharmacy, University College London, London, UK.
Ian C K WongResearch Department of Practice and Policy, School of Pharmacy, University College London, London, UK.
Li WeiResearch Department of Practice and Policy, School of Pharmacy, University College London, London, UK.
Kenneth K C ManResearch Department of Practice and Policy, School of Pharmacy, University College London, London, UK kenneth.man@ucl.ac.uk.ORCID 0000-0001-8645-1942

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo estimate the effect of gabapentinoid treatment on self-harm.

designA population based self-controlled case series study.

settingUK Clinical Practice Research Datalink Aurum database linked to the Hospital Episode Statistics and Office for National Statistics databases.

participants10 002 adults (aged ≥18 years), with gabapentinoid prescriptions, who had an incident event of self-harm between 1 January 2000 and 31 December 2020. Individual censoring occurred on the date of epilepsy, substance misuse, or cancer diagnosis.

main outcome measuresCrude incidence rates of self-harm in different risk periods: 90 days before gabapentinoid treatment, gabapentinoid treatment period, 14 days after treatment periods, and reference periods were calculated. Conditional Poisson regression derived the incidence rate ratio and 95% confidence intervals (CIs) to evaluate the risk of self-harm in different risk periods, compared with reference period for each individual.

results1 503 597 individuals received gabapentinoid prescriptions and 10 002 individuals were included in the analysis. The incidence rate of self-harm per 100 person years was 16.79 (95% CI 16.65 to 16.92) in the 90 days before treatment period, 9.66 (9.62 to 9.70) in the treatment period, 29.60 (29.09 to 30.11) in the 14 days after treatment period, and 6.75 (6.74 to 6.77) in the reference period. The results yielded an increased risk of self-harm during the 90 day period before treatment, with an adjusted incidence rate ratio of 1.69 (95% CI 1.55 to 1.85). The spline based analysis showed that the risk of self-harm declined gradually around the time of treatment initiation and returned to reference level during the treatment period (adjusted incidence rate ratio 1.06 (0.98 to 1.13)). Adjusted incidence rate ratio for self-harm increased within 14 days after treatment cessation (3.02 (2.53 to 3.60)). The findings remained consistent throughout a series of subgroups and sensitivity analyses.

conclusionsThe association between gabapentinoids and risk of self-harm seems to be multifaceted: an elevated risk of self-harm is present before initiation of gabapentinoid treatment, which persists during the initial phase of the treatment period, and rises again shortly after treatment discontinuation. These findings do not support a direct effect of gabapentinoid treatment on self-harm but underscore the necessity for close patient monitoring of self-harm throughout the gabapentinoid treatment journey.

Indexed as

AnticonvulsantsGabapentinSelf-Injurious BehaviorAdolescentAdultAgedCase-Control StudiesEpilepsyFemaleHumansIncidenceMaleMiddle AgedRisk FactorsUnited KingdomYoung AdultAnticonvulsantsGabapentin

Identifiers

PMID40306941
PMCPMC12129043

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Registered trials

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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.