TY - JOUR
PY - 2021//
TI - Characteristics of fatal gabapentinoid-related poisoning in Australia, 2000-2020
JO - Clinical toxicology (Philadelphia, Pa.)
A1 - Darke, Shane
A1 - Duflou, Johan
A1 - Peacock, Amy
A1 - Farrell, Michael
A1 - Lappin, Julia
SP - ePub
EP - ePub
VL - ePub
IS - ePub
N2 - INTRODUCTION: Gabapentinoids are centrally active GABA agonists whose use has increased substantially in the past decade. The current study aimed to provide a comprehensive clinical profile of a national case series of fatal poisonings related to gabapentinoids.
METHODS: Retrospective study of all deaths due to drug toxicity in Australia in which gabapentinoids were a contributory mechanism, retrieved from the National Coronial Information System (2000-2020). Information was collected on case characteristics, toxicology and major organ pathology.
RESULTS: A total of 887 cases were identified, with a mean age of 45.7 years and 55.2% being male. Death was due to accidental toxicity in 81.3% of cases and intentional in 18.7%. Pre-existing disease was co-contributory to drug toxicity in 19.5%. Pregabalin was present in 92.9% of cases, with a median blood concentration of 7.6 mg/L (range 0.1-850.0 mg/L). Gabapentin was present in 7.2%, with a median blood concentration of 9.5 mg/L (range 0.5-1940.0 mg/L). Both pregabalin and gabapentin were present in five cases. No other gabapentinoids were detected. Drugs other than gabapentinoids were present in 99.8%, most frequently opioids (90.1%), hypnosedatives (76.9%) and antidepressants (60.5%). A body mass index in the obese range was seen in 45.4%. Clinically significant pre-existing disease was common, notably cardiomegaly (24.9%), emphysema (20.2%), nephrosclerosis (18.7%) and severe hepatic steatosis (11.7%).
CONCLUSIONS: The concomitant use of other drugs was close to universal, with CNS depressants predominating. Mental health problems, chronic pain and substance misuse were prominent.
Language: en
LA - en SN - 1556-3650 UR - http://dx.doi.org/10.1080/15563650.2021.1965159 ID - ref1 ER -