Abstract:
The Australian Therapeutic Goods Administration\'s approved indications for prescription of gabapentinoids are refractory focal epilepsy and neuropathic pain. Use of gabapentinoids outside of the approved indications is common, but evidence for this is limited, especially for chronic nonspecific back pain and nonradicular leg pain. Some effects of gabapentinoids encourage their nonmedical use (e.g. euphoria, sedation, disinhibition). Widespread nonmedical use has increased the incidence of accidental and deliberate poisonings. Dependence may develop with chronic use of gabapentinoids and abrupt cessation may induce withdrawal symptoms. If the indication for continued use is unclear, gradual dose tapering as a means of deprescribing is recommended. Clinicians should consider the indication, patient characteristics and harm-benefit profile when prescribing gabapentinoids. Some people, such as those with kidney disease, have an increased risk of harm when using these drugs.
摘要:
澳大利亚治疗用品管理局批准的加巴喷丁类药物处方适应症是难治性局灶性癫痫和神经性疼痛。在批准的适应症之外使用加巴喷丁类药物是常见的,但是这方面的证据是有限的,尤其是慢性非特异性背痛和非神经根性腿痛。加巴喷丁类药物的某些作用鼓励其非医疗用途(例如,欣快感,镇静,去抑制)。广泛的非医疗使用增加了意外和故意中毒的发生率。长期使用加巴喷丁类药物可能会产生依赖性,突然停止可能会引起戒断症状。如果继续使用的指征不清楚,建议逐渐减少剂量作为非处方的一种方法。临床医生应该考虑适应症,处方加巴喷丁类药物时的患者特征和获益概况。有些人,比如那些患有肾脏疾病的人,使用这些药物时,会增加伤害的风险。