Dangerous Combinations: Gabapentinoids Increase Risk of Fatal Poisoning – LäkemedelsVärlden

People who take gabapentinoids, a class of medication increasingly prescribed for chronic pain, face a significantly higher risk of drug poisoning when also taking other medications, according to a new study by researchers at University College London.

The study, published in PLOS Medicine on 16 April 2026, found that combining gabapentinoids with benzodiazepines doubles the risk of hospitalisation for drug poisoning, while adding opioids increases the risk by 30%.

Gabapentinoids, which include drugs such as gabapentin and pregabalin, are widely prescribed for conditions like epilepsy, nerve pain, and anxiety disorders. They have become the seventh most commonly prescribed medication in the United States and have seen a more than fourfold increase in use across 65 countries from 2008 to 2018.

The researchers analysed data from over 16,800 individuals in the UK who had been prescribed a gabapentinoid and hospitalised at least once for drug poisoning, using up to ten years of records from the Clinical Practice Research Datalink linked to hospital and mortality data.

Risk of drug poisoning was found to be highest in the period before starting gabapentinoid treatment, with an adjusted incidence rate ratio of 2.09 in the 90 days prior to initiation. During the first 28 days of treatment, the risk remained elevated at 1.81 times baseline, before declining to 1.11 in the later stages of treatment.

The study authors noted that gabapentinoids are often started during times of heightened vulnerability to drug poisoning, such as when patients experience worsening symptoms and seek additional medications. While the risk decreases after treatment begins, it can remain elevated for months, suggesting that gabapentinoids may not effectively reduce long-term drug poisoning risks in this population.

Dr Kenneth Man, lead author from the UCL School of Pharmacy, emphasized that despite being promoted as a safer alternative to opioids, gabapentinoids carry significant risks when combined with other central nervous system depressants. He urged clinicians to exercise greater caution when prescribing these drugs, particularly in patients already using benzodiazepines or opioids.

The findings highlight the importance of medication review and patient monitoring when initiating gabapentinoid therapy, especially in individuals with a history of substance use or concurrent use of sedative medications.