天美传媒

Abstract

In this article the author explores the risks associated with the prescription of pregabalin (Lyrica) to those patients who have had a prior history of alcohol and/or other substance misuse problems. It is suggested that the abuse potential of pregabalin may have been underestimated and that a number of recent studies tend to indicate there is in fact a considerable risk of abuse of pregabalin when this drug is prescribed to patients who have a history of substance misuse. Pregabalin (Lyrica) is a novel gamma-aminobutyric acid (GABA) analog that is approved for the treatment of neuropathic pain and partial-onset seizures. Pregabalin selectively binds to the alpha 2 delta subunit of voltage-gated calcium channels. In so doing the release of excitory neuro-transmitters are inhibited and neuronal GABA levels are increased. Pregabalin has also been approved in the European Union and Russia (but not in the US) for treatment of Generalized Anxiety Disorder (GAD). The anxiolytic effects of pregabalin occur rapidly after administration, similar to the benzodiazepines, which gives pregabalin an advantage over many anxiolytic medications. However the Drug Enforcement Agency in the US has denoted pregabalin as a Schedule V drug under the terms of the Controlled Substances Act. This means that pregabalin is considered to be a drug with a low potential for abuse relative to those drugs, such as the benzodiazepines, coded under Schedule IV of the Controlled Substances Act.

Biography

Alistair D. Sweet MA (PsyA), MSSc, Dip.Couns (PsyD), MBACP is a Senior Psychotherapist and Head of Clinical Services with Addiction NI, based in Belfast, United Kingdom. Mr Sweet is also an Honorary Lecturer and Clinical Supervisor on the Doctorate in Clinical Psychology, School of Psychology, Queens University, Belfast. Alistair also works in private practice as a Consultant Psychotherapist at the Abbotsford Institute in Belfast. His research work has appeared internationally in a range of peer reviewed journals including The British Journal of Psychotherapy, The International Forum of Psychoanalysis and The American Journal of Psychotherapy. Alistair is an Editorial Board Member of the Journal of Psychology and Psychotherapy (Los Angeles) and of the Journal of Psychotherapy and Psychological Disorders, Henderson, Nevada, United States. In 2006 Alistair was awarded a Butler Trust Award for an outstanding contribution in the field of criminal justice psychotherapeutic treatment provision. Research interests include: Psychotherapy of the addictions, assessment of personality structure and defence mechanisms, disturbances of early attachments and the history and application of clinical object relations theory within psychoanalysis