ArticleThe Lancet regional health. Europe2025
High-dose use of pregabalin and gabapentin in France: a retrospective, population-based cohort study.
Article in The Lancet regional health. Europe, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.
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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
6 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pooled it
- Optimising the Therapeutic Window: A Systematic Review and Network Meta-Analysis of Pregabalin Dosing Strategies for Painful Diabetic Neuropathy.Diabetes, obesity & metabolism · 2026Pooled it
- Patterns of psychotropic drug dispensation in Portugal amidst the COVID-19 pandemic and beyond.Scientific reports · 2026Article
- Psychoactive prescription drug use and misuse in patients on opioid agonist treatment.British journal of clinical pharmacology · 2026Article
- Prescription Trends and Clinical Decision-Making in Neuropathic Pain Pharmacological Treatment: Results From a Cross-Sectional Survey by the Spanish Pain Society.European journal of pain (London, England) · 2026Article
- Focus on 'Psychiatry and Addiction: A Multi-Faceted Issue'.Brain sciences · 2025Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Following recent developments regarding gabapentinoid (i.e., pregabalin and gabapentin) abuse and misuse in France, this study aims to describe new users of gabapentinoids from 2017 to 2021, estimate the incidence of high-dose use, and identify the associated factors. Methods: We used the French National Health Data System. In this retrospective, population-based cohort study, we included new users of pregabalin and gabapentin, aged 18 years and older, in two separate cohorts. We defined new users as patients with at least three dispensings of either pregabalin or gabapentin within a 12-month period, with the first dispensing occurring from January 1, 2017 to December 31, 2021, and no dispensing in the previous 12 months. We used high-dose use as a proxy for potential abuse and misuse. We defined high-dose use as exposure to an average daily dose exceeding the maximum recommended dose. We followed patients for up to 24 months. Then, we calculated the cumulative incidence of high-dose use in each cohort. Finally, we identified factors associated with high-dose use in each cohort using Cox models. Findings: We included 898,887 new users of pregabalin and 271,832 new users of gabapentin. Since 2020, the monthly number of new users of pregabalin has decreased and the monthly number of new users of gabapentin has increased. In both cohorts, the median age was 64 years, and about 60% of patients were women. Incidence rates were 26.0 [95% CI: 25.8, 26.3] per 1000 person-years for high-dose use of pregabalin and 10.0 [9.7, 10.3] per 1000 person-years for high-dose use of gabapentin. During treatment episodes where high-dose use was identified, patients in the pregabalin cohort used higher daily doses than those in the gabapentin cohort. The main factors associated with high-dose use of pregabalin and gabapentin included prior exposure to the other gabapentinoid, prior exposure to opioid agonist treatments, prior exposure to strong opioid analgesics, younger age, being a man, paraplegia, active cancers, and higher number of prescribers. Interpretation: Prescribers should exercise extra caution when initiating gabapentinoids in patients at risk of high-dose use. Funding: This study is part of the METEOR study, which was funded by EPI-PHARE (https://www.epi-phare.fr/).
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