Growing Evidence of Harms Associated with Gabapentinoid Drugs

Gabapentinoids (gabapentin and pregabalin) are widely used off-label for chronic pain, despite limited evidence of benefit (NEJM JW Gen Med May 1 2019 and JAMA Intern Med 2019; 179:695). Although their side effects include sedation and dizziness, widespread use of gabapentinoids suggests that clinicians perceive their potential harm to be minimal. Three studies published in 2024 challenge that perception.

• In 2019, the U.S. FDA issued a warning about “severe breathing difficulties” associated with gabapentinoids. To investigate further, Canadian researchers identified a cohort of patients with chronic obstructive pulmonary disease (COPD) and matched 14,000 new users of gabapentinoids to 14,000 nonusers based on duration of COPD, age, sex, and…