Gabapentinoids, Used for Epilepsy and Pain Relief, Associated with Exacerbation of Pulmonary Disease Interview with:
Christel Renoux,  MD, PhD
Associate Professor
Dept. of Neurology & Neurosurgery
McGill University
Centre For Clinical Epidemiology H-416.1
Jewish General Hospital – Lady Davis Research Institute
Montreal Canada and
Alvi Rahman MSc
Pharmacoepidemiologist | HEOR Consulting
McGill University
Montreal, Quebec, Canada What is the background for this study?

Response: . Gabapentinoids are anticonvulsant drugs that include the two drugs, gabapentin and pregabalin. They are indicated for the treatment of epilepsy and neuropathic pain, with minor variations between countries (pregabalin is also indicated for generalized anxiety disorders in some countries). However, they are often prescribed off-label for any type of pain, sometimes with the perception that they may be a safer alternative to opioids. Yet, gabapentinoids also may have serious adverse effects owing to the depressant effect they have on the central nervous system, which can lead to sedation or respiratory depression.

Several public health agencies have warned of breathing problems related to gabapentinoids, including the U.S. Food and Drug Administration (FDA), Health Canada, and the European Medicines Agency. Specifically, the FDA suggested that patients with respiratory risk factors, including those with chronic obstructive pulmonary disease (COPD) may be at higher risk. These warnings were based mainly on case reports, and there was a lack of large population-based studies on this topic, which led us to conduct this study assessing the association between gabapentinoid use and severe exacerbation of COPD (hospitalization).

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