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Unlike in many other developed countries, rates of pregabalin use and overdose have leveled off and declined in Australia since 2018 following high-profile media coverage of harms, restrictions on prescriptions and supply, and new boxed warnings, finds a study published by The BMJ.

Compared with earlier trends, prescriptions were 25% lower and intentional poisoning calls 47% lower than expected, the results show.

While the researchers can't establish a direct (causal) link between this decline and these measures, they say the results are promising and may help inform similar interventions elsewhere.

Pregabalin is a gabapentinoid drug used to treat epilepsy, nerve pain and anxiety disorders. Alongside increased use in recent years, there is mounting evidence of misuse, dependence and harms in Europe, the U.S., Asia and Australia.

For example, in the U.K., one-third of substance use deaths involve a gabapentinoid, predominantly pregabalin, and deaths involving gabapentinoids more than doubled between 2018 and 2022. Similar concerns have been reported elsewhere, prompting many countries to implement restrictions and interventions.

To evaluate recent trends in pregabalin use and misuse across Australia, researchers examined dispensing claims and poison center data from 2016 to 2024 with a focus on three key events: widespread media reporting on the harms of pregabalin in December 2018, tighter prescribing restrictions from April 2020 and the introduction of boxed warnings in February 2021.

During the study, 3,441,851 pregabalin prescriptions were dispensed to 227,864 people, and 4,871 pregabalin overdose calls were reported to the poison center.

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