Clinical Audit of Gabapentin use in a Mental Health Hospital in Qatar

Bakground: Gabapentin was approved by FDA for the treatment of epilepsy, and as an analgesic for post-herpetic neuralgia (PHN). Gabapentin has been prescribed off-label for a wide range of disorders. Off-label use of gabapentin has been estimated to range from 83 to 95% of all its use. In the last few years, gabapentin has been becoming dispensed extensively for appropriate and inappropriate uses; meanwhile, drug-monitoring agencies have warned for potential abuse liabilities associated with gabapentin. The principal population at risk for addiction consists of patients with history of substance use disorders (SUD), mostly pregabalin and opioids. Purpose: To audit the appropriate use of gabapentin among a cohort of drug users, followed by subgroup analysis to determine the likelihood of drug abuse, misuse and/or diversion. Results: A total of 76 patients were included in the study. 99% of candidates used Gabapentin for off label indications, 30% for managing of behavioral symptoms related to dementia (BPSD). 27%, of the cohort used the medication had a confirmed history of substance-use disorder (SUD). One patient found to receive an inappropriate dose with regard to Creatine clearance Crcl. Conclusion: The data analysis has revealed that almost all gabapentin use in this setting was for off-label indications. Without placing limitations on the prescribing of this medication, it is expected that misuse of it by patients will continue to upsurge. This study highlights the need to standardize a hospital protocol for Gabapentin use within this facility, especially among patients with a history of substance- use disorder.