Is there a recreational misuse potential for Pregabalin? Analysis of anecdotal online reports in comparison with related Gabapentin and Clonazepam data

Background: Although pregabalin abuse potential is reportedly low, online data related to its recreational misuse potential have recently been identified. We aimed here at formally analysing pregabalin misuse web reports and comparing these with data pertaining to similar drugs, e.g. gabapentin and clonazepam, for which an abuse potential has already been identified. Methods: An 8-language analysis of the online information on pregabalin acquisition/misuse was carried out. An initial sample of 203 websites was considered and 108 relevant websites were monitored on a regular basis. To obtain material relating to gabapentin and clonazepam, an English-language search was carried out and 32 relevant websites were examined. Results: Misuse of pregabalin, which is commonly offered for sale online, was allegedly associated with sedative and/or psychedelic effects. This was associated with both higher dosages than clinically advised and idiosyncratic (i.e.: IV, rectal, intranasal) drug intake modalities. Although perceived as less powerful than pregabalin, gabapentin misuse was associated with similar sedative/psychedelic effects. Clonazepam allegedly induced either sedation or stimulation, depending on the dosage. Conclusions: Pregabalin experimenters might be profiled as individuals with a history of recreational polydrug misuse. Pregabalin misuse might be facilitated by easy online accessibility; potency; and peculiar, including anxiolytic, psychoactive effects. Physicians should carefully evaluate patients for history of drug abuse and observe them for signs of pregabalin/gabapentin/clonazepam misuse.