Rise of Pregabalin Poisoning and Abuse Cases in Serbia: A Ten-Year Retrospective Study

Figures & data

Figure 1 Pregabalin consumption and poisoning cases in National Poison Control Center of Serbia for ten-year period (2012–2021).

Table 1 The Main Characteristics of the Study Population (Pregabalin-Related) and Differences Among Suicide-Related Events, Misuse and Abuse Cases

	All Exposures	Misuse	Suicide-Related Events	Abuse	p
Number of cases (n)	357	108 (30.2%)	146(40.9%)	103 (28.9%)	-
Number of patients (n)	287	91 (31.7%)	112 (39.0%)	84 (29.3%)	-
Gender (n)
Male	148 (51.6%)	44 (48.3%)	33 (29.5%)	71 (84.5%)	<0.001
Female	139 (48.4%)	47 (51.9%)	79 (70.5%)	13 (15.5%)
Age (years)
Median	37	42	41	26^a,b	< 0.001
Q1 – Q3	26–46	35–54	33–52	23–32
Range	13–87	13–87	16–84	15–45
History problematic substance use (n)	117 (40.8%)	28 (30.8%)	58 (51.8%)	31 (36.9%)	ns
Migrant population	55 (19.2%)	7 (7.7%)	-	48 (57.1%)	<0.001
Dose documented cases (mg)	213 (59.7%)	n =76 (70.3%)	n=92 (63.0%)	n=45 (43.7%)	-
Median	500	237	600	600^a	< 0.001
Q1 – Q3	250–900	150–475	350–1300	450–1000
Range	25–6900	50–6900	25–4700	150–4200
Isolated pregabalin ingestion (n)	38 (10.6%)	6 (5.6%)	12 (8.2%)	20 (19.4%)	0.002
Co-ingested substances (n)	319 (89.4%)	102 (94.4%)	134 (91.8%)	83 (80.6%)
Most often co-ingested groups of psychoactive substances (n)		Benzodiazepines 84 (77.8%) Anticonvulsants 37 (34.3%) Antidepressants 25 (23.1%)	Benzodiazepines 118 (80.8%) Antidepressants 48 (32.9%) Antipsychotics 40 (27.4%)	Benzodiazepines 70 (68.0%) Ethanol 21 (20.4%) Opioids 16 (15.5%)	-

Notes: For continuous data statistical significance was determined with the Mann–Whitney U-test by comparison between the: abuse and misuse group (^ap < 0.001), abuse and suicide-related events (^bp < 0.001). For categorical data statistical difference between the groups was determined with Chi-Square test.

Abbreviations: n, number; Q₁ – Q₃, Q₁ (25. percentile) – Q₃ (75. percentile); ns, not statistically significant.

Figure 2 Age distribution (%) of the study population in misuse, abuse and suicide related events.

Table 2 Clinical Features of Study Population and Differences Among Pregabalin Isolated and Polysubstance Poisonings

	All Exposures (n=357)	Pregabalin Only (n=38)	Co-Ingested Substances (n=319)	p
Dose documented cases (mg)	n=213 (59.7%)	n=26 (68.4%)	n=187 (58.6%)
Median	500	600	500	0.04
IQR	250–900	450–1050	225–900
Range	25–6900	100–3750	25–6900
Concentration documented cases (mg/L)	n=104 (29.1%)	n=7 (18.4%)	n=97 (30.4%)
Median	6.23	14.30	6.13	ns
Q1 – Q3	1.79–12.59	7.26–18.98	1.78–11.70
Range	0.10–76.16	1.67–28.3	0.1–76.16
Disposition (n)
Emergency department	230 (64.4%)	30 (78.9%)	200 (62.7%)	0.03
Admitted to clinic	127 (35.6%)	8 (21.1%)	119 (37.3%)
Clinical findings (n)
Coma	91 (25.5%)	4 (10.5%)	87 (27.3%)	0.03
Hypotension	27 (7.6%)	0	27 (8.5%)	ns
Bradycardia	9 (2.5%)	1 (2.6%)	8 (2.5%)	ns
Seizure	2 (0.6%)	0	2 (0.6%)	ns
Complications (n)
Pneumonia	40 (11.2%)	1 (2.6%)	39 (12.3%)	ns
Rhabdomyolysis	21 (5.9%)	0	21 (6.6%)	ns
Treatment (n)
Intubation	25 (7.0%)	0	25 (7.8%)	ns
Vasopressors	11 (3.1%)	0	11(3.4%)	ns
Mechanical ventilation	8 (2.2%)	0	8 (2.5%)	ns
PSS score (n)
None/Minor - 0/1	231 (64.7%)	33 (86.8%)	199 (62.4%)	0.01
Moderate/Severe - 2/3	122 (34.1%)	5 (13.2%)	116 (36.3%)
Fatal - 4	4 (1.1%)	0	4 (1.3%)	-
Length of hospital stay (h)
Median	6	4	6	<0.001
Q1 – Q3	4–24	3–6	4–30
Range	1–624	1–84	1–624

Notes: For continuous data statistical difference between the groups was determined with the Mann–Whitney U-test. For categorical data statistical difference between the groups was determined with Chi-Square test.

Abbreviations: n, number; h = hours; Q₁, Q₃ = Q₁ (25. percentile) – Q₃ (75. percentile); ns, not statistically significant.