Deaths involving gabapentin and pregabalin, Scotland, 2000-2024: a descriptive account

Gabapentin and pregabalin, while prescribed for conditions like neuropathic pain and epilepsy, have shown increasing misuse, raising concerns about their potential for harm, especially with other central nervous system (CNS) depressants. This study describes the characteristics of deaths associated with gabapentin and/or pregabalin in Scotland from 2000 to 2024, using data provided by the National Records of Scotland. The analysis included socio-demographics, drugs implicated, and cause and manner of death. Out of 3,813 deaths where gabapentin or pregabalin was listed in the Poison field, the number of deaths increased from 2008 to 2019, with a slight recovery in 2023 after falls in 2020 and 2021. The majority (65.6%) of deaths involved males, and the mean age at death was 43.0 years. Polypharmacy was common, with 98.9% of cases involving at least one other drug, typically opioids or benzodiazepines. Accidental poisoning was the most common cause of death (90.7%), with 4.7% attributed to suicide. There was no death involving a gabapentinoid on its own. Scottish trends in prescribing and deaths align with concerns about rising gabapentinoid misuse and associated harms across the United Kingdom. The findings underscore the risk of polypharmacy, particularly with CNS depressants, and highlight the need for cautious prescribing and greater awareness of the dangers of co-consumption.