Gabapentin-related suicide: Myth or fact?

Abstract

Background: The opioid epidemic in America is real and is estimated to be the number one cause of death in adults under 50 years of age. Finding alternative analgesic medications is part of the effort to decrease the prescription of narcotics, with gabapentin being at the top of the list.

Case description: In the present case, we discuss the side-effects of gabapentin, used as part of the multimodal treatment approach of painful spinal degenerative disease. The patient stated that he had noticed personality changes after gabapentin was initiated, and that he had become more depressed, frustrated, and aggressive. His uncontrolled pain and acute mood changes led him to attempt suicide by hanging himself. Gabapentin was discontinued and the patient's suicidal ideation completely subsided.

Conclusion: It is imperative to screen, identify, and appropriately manage patients with underlying psychiatric disorders prior to initiating pain management with gabapentin. Therefore, it is crucial to raise awareness of gabapentin as a potential cause of depression, aggressive behavior, and suicidal ideation.

Keywords: Chronic low back pain; gabapentin; suicide.

Figure 1

IMS Health data, Gabapentin dispensed prescriptions, in millions[33]

Figure 2

Clinical Toxicology report for Gabapentin exposure. American Association of Poison Control Centers Annual reports[30]

Figure 3

The reason for Gabapentin poisoning. American Association of Poison Control Centres AAPCC[30]