pregabalin and Hallucinations

Synthetic cannabinoid receptor agonists (SCRA) are commonly encountered new psychoactive substances. Here we report the recent detection of ADB-BUTINACA in samples from patients attending United Kingdom emergency departments with toxicity after suspected drug misuse and describe the associated clinical features.. Consenting adults (≥16 y) presenting to participating hospitals with toxicity after suspected drug misuse have been included in the Identification Of Novel psychoActive substances (IONA) study since March 2015. Demographic and clinical features are recorded and blood and/or urine samples analysed using high-resolution accurate mass liquid chromatography-mass spectrometry.. By December 2021, analytical data were available for 1279 IONA participants and ADB-BUTINACA was detected in at least one sample from 10 (9 males, age range 16-51 median 45 years), all presenting since February 2021. Smoking 'spice' was reported by four patients, two had ingested edible "cannabis" gums and four reported heroin use (2 intravenous, 1 smoked, 1 route not known). Co-use of pregabalin (oral) and crack cocaine (smoked) were also reported. In 3 cases ADB-BUTINACA was the only substance detected, while in seven other substances of misuse were also detected including other SCRA, opioids, benzodiazepines cocaine and pregabalin. Clinical features reported in these 2 groups respectively included reduced level of consciousness (3/3, 6/7), agitation (0/3, 4/7), tachycardia (0/3, 3/7), seizures (1/3, 1/7), hallucinations (1/3, 1/7), hypotension (1/3, 1/7). Metabolic acidosis (1/3, 0/7) and respiratory acidosis (1/3, 0/7), All 10 patients recovered with supportive care, including intubation and ventilation for one case. The median length of hospital stay was 19 h (range 2.6-131 h).. ADB-BUTINACA has recently emerged as a drug of misuse in England. Clinical features of toxicity are consistent with those of other SCRA and include reduced level of consciousness, respiratory and/or metabolic acidosis, seizures, confusion and hallucinations.

Topics: Adolescent; Adult; Benzodiazepines; Cannabinoid Receptor Agonists; Crack Cocaine; Emergency Service, Hospital; England; Hallucinations; Heroin; Humans; Male; Middle Aged; Pregabalin; Seizures; Young Adult

Pregabalin is an anticonvulsive, analgesic and anxiolytic medication. The typical side effects include dizziness, somnolence and weight gain. Few studies or case reports have demonstrated psychiatric side effects resulting from its use.. We present a patient who suffered visual hallucinations and agitation associated with an increase in pregabalin dose, resolving completely after pregabalin discontinuation.. Acute visual hallucinations should be considered in the clinical spectrum of very rare side effects of pregabalin use, especially at higher doses. Tapered discontinuation of the medication can improve and resolve symptoms.

Topics: Adult; Akathisia, Drug-Induced; Analgesics; Female; Hallucinations; Humans; Pregabalin

A 38-year-old man was referred to the psychiatric department due to auditory hallucinations, suicidal ideation and a large daily intake of 8.4 g pregabalin. The Danish National Medication Register showed that the patient had bought pregabalin 21 times within the last two months, a total of 487.2 g pregabalin. Withdrawal symptoms disappeared within 48 hours, psychotic experiences and the suicidal ideations faded during the next couple of weeks. High doses of pregabalin are tolerated with surprisingly few toxicological consequences, though lethal cases have been described. Pregabalin abuse, however, can lead to dependency.

Topics: Adult; Anti-Anxiety Agents; Anxiety; Hallucinations; Humans; Male; Pregabalin; Substance Withdrawal Syndrome; Substance-Related Disorders; Suicidal Ideation

Charles Bonnet syndrome is a condition characterised by the presence of visual hallucinations in patients having visual impairment most commonly reported in the seventh decade. We describe a case of a 55-year-old lady who had developed retinopathy causing significant visual loss secondary to diabetes mellitus. She had started seeing images of men for the past 2 months which made her feel uncomfortable and seek psychiatric help. She was aware that the hallucinations were not real but a part of her imagination. A detailed history did not reveal any psychopathology but the patient had several medical complications due to her uncontrolled diabetes. Pregabalin, which was started for her neuropathy, dramatically remitted her symptoms within 2 days.

Topics: Analgesics; Diabetic Neuropathies; Diabetic Retinopathy; Female; gamma-Aminobutyric Acid; Hallucinations; Humans; Middle Aged; Pregabalin; Syndrome; Vision Disorders

Topics: Adult; Analgesics; Delirium; Female; gamma-Aminobutyric Acid; Hallucinations; Humans; Low Back Pain; Pregabalin; Psychoses, Substance-Induced