Special Edition of Prescrire International

ADVERSE EFFECTS

6- Prescrire Rédaction “Méthylphénidate: beaucoup d’adultes parmi les nouveaux utilisateurs en France” Rev Prescrire 2018; 38 (422): 912. 7- Huybrechts F et al. “Association between Methylphenidate and AmphetamineUse inPregnancy andRisk of CongenitalMalformations. A Cohort Study from the International Pregnancy Safety Study Con- sortium” JAMA Psychiatry 2018; 75 (2): 167-175. 8- Nörby U et al. “Perinatal outcomes after treatment with ADHD medication during pregnancy” Pediatrics 2017: 140 (6): 11 pages. 9- Cohen JM et al. “Placental complications associated with psycho- stimulant use in pregnancy” Obstet Gynecol 2017; 130 (6): 1192-1201. 10- Centre de référence sur les agents tératogènes“Méthylphénidate” 20December 2017. www.lecrat.fr accessed 4 February 2019: 2 pages. 11- US FDA “Full prescribing information-Concerta” 1 April 2017: 28 pages. 12- “Teris Teratogen Information System”. depts.washington.edu/ terisdb accesed April 2018. 13- “Shepard’s Catalog of Teratogenic Agents” 28 November 2016. depts.washington.edu/terisdb accessed October 2018.

14- “Reprotox” 9 March 2018. reprotox.org accessed October 2018. 15- “Briggs Drugs in Pregnancy and Lactation. A Reference Guide to Fetal and Neonatal Risk” 11 th ed. Lippincott Williams and Wilkins, Philadelphia 2011. 16- Prescrire Rédaction “Mécanisme d’action des amphétaminiques en bref” Rev Prescrire 2015; 35 (376): 107. 17- PrescrireRédaction“FicheM2. Les sympathomimétiques en bref” Interactions Médicamenteuses Prescrire 2019. 18- “Methylphenidate”. In:“MartindaleTheCompleteDrugReference” The Pharmaceutical Press, London. www.medicinescomplete.com accessed 29 December 2018: 15 pages. 19- ANSM “Méthylphénidate: données d’utilisation et de sécurité d’emploi en France” April 2017: 34 pages. 20- August P et al. “Preeclampsia: Clinical features and diagnosis” UpToDate. www.uptodate.com accessed 7 October 2018: 25 pages. 21- Lemelin M et al. “Maternal ADHD medication use during preg- nancy and the risk of ADHD in children” Birth Defects Res 2018; 110 : 759. Prescrire Int • June 2018  In practice  The increased use of pregabalin and gabapentin is correlated with an increase in mor- tality linked to these substances.That represents a strong argument for not using them routinely, all the more so since it is sometimes difficult to stop these drugs, as a result of withdrawal symptoms. With patients already on treatment, there should be a regular reassessment of its value, the doses actually being taken and the adverse effects, whose link with the drug is sometimes unrecognised. ©Prescrire ▶▶ Translated from Rev Prescrire November 2018 Volume 38 N° 421 • Page 830 2- Lacobucci G“UK government to reclassify pregabalin and gabapen- tin after rise in deaths” BMJ 2017; 358 : j4441 doi: 10.1136/bmj.j4441. 3- Office for national statistics “Death related to drug poisoning in England andWales: 2016 registrations” 2 August 2017: 34 pages. 4- ANSM“RCP-Neurontin 400 mg” 22 January 2018: 11 pages.
 5- European Commission “SPC-Lyrica” 1 st August 2018: 111 pages. 6- Prescrire Editorial Staff “Gabapentin and pregabalin: abuse and addiction” Prescrire Int 2012; 21 (128): 152-154. 1- “Gabapentin and risk of severe respiratory depression” DrugTher Bull 2018; 56 (1): 3-4.


Gabapentin and pregabalin: deaths reported

At the end of 2017, the British Medicines and Healthcare products Regulatory Agency (MHRA) announced an increase in reports of deaths linked to pregabalin ,

an analogue of gamma-aminobutyric acid (GABA): 4 deaths had been reported in 2012 and 111 deaths in 2016.The number of deaths linked to gabapentin , another substance closely related to pregabalin , was 8 in 2012 and 59 in 2016 (1-3). Pregabalin and gabapentin are authorised for use in epilepsy, anx- iety and chronic neuropathic pain (4,5). Pregabalin and gabapentin carry a risk of respira­ tory depression, which is increased in patients having a respiratory or neurological disorder, in renal failure, when in combination with a central nervous system depressant, particularly an opioid, a benzodiazepine or alcohol, and in the elderly (1-5). Pregabalin and gabapentin carry a risk of addiction associated with withdrawal symptoms and abuse with increasing doses (6). In 5 years, the number of prescriptions in the United Kingdom increased by 350% for pregabalin and by 150% for gabapentin (2). One cause put forward is that these drugs are being used too readily and their use is becoming “routine”.

Prescrire Int • April 2019

P rescrire I nternational S pecial E dition 2019 • P age 11