New research from University of Sydney finds that while pregabalin use and overdose continue to rise in many developed countries, rates in Australia have stabilised and fallen since 2018 following a series of regulatory and public awareness measures including high profile media coverage of harms, restrictions on prescriptions and supply, and new safety warnings on medicine boxes. 

Published in the BMJ, the study shows that prescriptions of pregabalin (Lyrica) in Australia were 25 percent lower and intentional poisoning calls were 47 percent lower than expected, compared with earlier trends.

Lead researcher Associate Professor Rose Cairns from Sydney School of Pharmacy in the Faculty of Medicine and Health said that while they can’t attribute a causal link between lower rates of pregabalin use and the public awareness measures, the results in Australia are promising and may help inform similar interventions in other countries.

“Pregabalin is a gabapentinoid drug used to treat nerve pain, epilepsy, and anxiety disorders. Alongside increased use in recent years, there is mounting evidence of misuse, dependence, and harms in Europe, the USA, Asia, and Australia.

“In the UK, one third of substance use deaths involve a gabapentinoid, predominantly pregabalin, and deaths involving gabapentinoids have more than doubled from 2018 to 2022. Similar concerns have been reported elsewhere, prompting many countries to implement restrictions and interventions,” she said.

The study

To evaluate recent trends in pregabalin use and misuse across Australia, the researchers examined dispensing claims and poison centre data from 2016 to 2024 with a focus on three key events: 

• widespread media reporting on the harms of pregabalin in December 2018

• tighter prescribing restrictions from April 2020

• the introduction of boxed warnings in February 2021.

During the study, 227,864 people were dispensed 3,441,851 pregabalin prescriptions and 4,871 pregabalin overdose calls were reported to the poisons centre.

Pregabalin use and overdose peaked in 2018 before declining. Three timepoints were observed when pregabalin dispensing decreased significantly: 

• in December 2018 (corresponding to high profile press coverage)

• in May 2020 (the month after tighter prescribing restrictions were introduced)

•  in December 2021 (following boxed warnings and the introduction of real time prescription monitoring).

“Compared with the projected historical trend, there was a 25 per cent decrease in dispensing, with approximately 118,390 fewer pregabalin prescriptions in December 2021, and an ongoing reduction of 0.7 per cent each month,” said Associate Professor Cairns.

“There was also a 47 percent decrease in overdose rates, with an estimated 41 fewer pregabalin overdose calls in December 2021, and an ongoing reduction of 1.6 percent each month.

“While these findings are positive, pregabalin use and overdose does remain high in Australia, with evidence for widespread use outside of approved indications.

“Ongoing monitoring of the misuse of pregabalin as well as further restrictions on prescribing and dispensing are still needed in Australia,” she said.

Research

Changes in pregabalin use and overdose after government interventions and media coverage: retrospective observational study doi: 10.1136/bmj-2026-101021

Editorial

Pregabalin: the case for dialling back on a mediocre analgesic doi: 10.1136/bmj-2026-101357

Funding

National Health and Medical Research Council