Evidence map›Paper›PMID 40999886›Full record

ArticleBritish journal of clinical pharmacology2026

Pregabalin dependence, withdrawal, suicidality and psychosis reports: A disproportionality analysis of the Australian adverse events database.

Amy G McNeilage, Ali Gholamrezaei, Bridin Murnion, Suzanne Nielsen, Claire E Ashton-James

Abstract read
In one paragraph

Article in British journal of clinical pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Amy G McNeilageSydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0001-7112-042X
Ali GholamrezaeiSydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0001-8674-450X
Bridin MurnionSydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0001-7791-3025
Suzanne NielsenMonash Addiction Research Centre, Eastern Health Clinical School, Monash University, Frankston, Victoria, Australia.ORCID https://orcid.org/0000-0001-5341-1055
Claire E Ashton-JamesSydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0001-5547-4295

Funding

Department of Education, Australian GovernmentNHMRC Investigator Grant Fellowship 2025894Pain Foundation Limited
6 · The paper itself

Abstract

aimsGlobally, Australia has the highest per capita consumption rate of pregabalin, commonly prescribed for neuropathic pain. Emerging evidence suggests pregabalin may be associated with the onset or recurrence of several potentially life-threatening psychiatric events in some individuals.

methodsWe conducted disproportionality analyses using case reports involving adverse events related to dependence, withdrawal, suicidality and psychosis, submitted to Australia's Therapeutic Goods Administration between 2005 and 2024. Reporting odds ratios (RORs) were calculated to determine whether these adverse events were disproportionately reported for pregabalin compared to all other drugs in the database and to an active comparator group of other neuropathic pain drugs (gabapentin, duloxetine and amitriptyline).

resultsCompared to all other drugs in the database, pregabalin showed strong signals of disproportionate reporting for drug abuse and dependence (ROR = 13.53, 95% confidence interval [CI]: 12.12, 15.10), drug withdrawal (ROR = 6.76, 95% CI: 4.99, 9.15), suicide and self-injury (ROR = 12.40, 95% CI: 10.71, 14.36), and psychosis and psychotic disorders (ROR = 5.81, 95% CI: 4.99, 6.76). When compared to other neuropathic pain drugs, the signal of disproportionate reporting remained for drug abuse and dependence (ROR = 1.38, 95% CI: 1.17, 1.62) and psychosis and psychotic disorders (ROR = 1.26, 95% CI: 1.002, 1.57), albeit with less pronounced effects.

conclusionsAdverse events related to drug dependence and psychosis are reported to the Australian pharmacovigilance database at a higher rate for pregabalin compared to other drugs, including other neuropathic pain drugs, signalling a potential concern that warrants further investigation.

Indexed as

Adverse Drug Reaction Reporting SystemsAnalgesicsPregabalinPsychoses, Substance-InducedSubstance-Related DisordersSubstance Withdrawal SyndromeAdultAustraliaDatabases, FactualFemaleHumansMaleMiddle AgedNeuralgiaPharmacovigilanceSuicideAnalgesicsPregabalinadverse drug eventsdrug dependencepharmacovigilancepregabalinpsychiatric disorders

Identifiers

PMID40999886
PMCPMC12850631

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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.