Pregabalin contributed to fatality of woman in New Zealand

Penygroes, New Zealand  Image: Google Maps

A forensic pathologist from Penygroes, New Zealand, determined that pregabalin, a medication used to treat neuropathic pain, was a contributing factor in a woman’s recent death.

Dr. Mark Lord noted that although physicians frequently prescribe pregabalin as a pain killer, drug addicts have misused it.

“But [pregabalin] is increasingly being used as a drug of abuse, giving a similar effect to that of ecstasy,” he said.

“It can have significant toxic effects and be made worse by alcohol.”

Since pregabalin has found uses outside of treating epilepsy, a surge in the number of prescriptions written for it was noted in another article.

Prescriptions for pregabalin and gabapentin increased more than tenfold in a decade, from 1 million in 2004 to 10.5 million in 2015, as their use was expanded outside epilepsy to treat neuropathic pain, anxiety, insomnia and other mental illnesses.

The toxic effects don’t result from using the medication for its intended purpose, but when mixing it with other drugs the results can be lethal.

Researcher Matthew Hickman, professor of public health and epidemiology, said doctors and people dependent on opioids needed to be aware that the number of overdose deaths involving the combination of opioids with gabapentin or pregabalin had increased substantially.

People using pregabalin for neuropathic pain need to be aware that its improper use can have potentially fatal consequences in extreme cases.

Unusual case of optic neuropathy and OTC sexual enhancement products

optic neuropathy PDEs

Can a certain type of optic neuropathy and unregulated use of some over-the-counter sexual enhancement products be linked?

Researchers from the Bascom Palmer Eye Institute at the University of Miami Miller School of Medicine in Miami, Florida found an unusual case which indicates PDE-5 inhibitors may some serious unintended side effects.

The case study

An article titled “Optic neuropathy associated with the use of over-the-counter sexual enhancement supplements,” described a patient who came in for treatment complaining of headaches, vision loss, and neuropathy in part of the right hand.

A 42-year-old man presented with right-sided headache and vision loss of the right eye, which deteriorated to a single quadrant of hand motion over 11 days.

Treatment and revelation

Even though the patient received the preferred high-dose steroid treatment for optic neuritis, orbital magnetic resonance imaging scans still displayed progressive orbital optic nerve enhancement in his eyes.

optic neuritisFurther questioning revealed he used “several over-the-counter sexual enhancement supplements prior to the onset of symptoms and throughout the course of his steroid treatment.”

After he stopped taking them, his headaches disappeared, vision and visual field subsequently improved.

About phosphodiesterase-5 inhibitors (PDE5I)

Long a mainstay in the treatment of erectile dysfunction(ED), phosphodiesterase-5 inhibitors have only recently received attention for a possible nonarteritic anterior ischemic optic neuropathy connection per a recent article by a New York doctor.

“Phosphodiesterase-5 inhibitors are used for treatment of erectile dysfunction and pulmonary arterial hypertension and have been implicated as a causative factor for development of nonarteritic anterior ischemic optic neuropathy (NAION). Controversy remains regarding a cause and effect between PDE5I use and NAION because the mechanism by which NAION occurs is still not well understood.”

Concluding remarks

The eye doctors point out this patient’s problems partially came from the  unsupervised use of supplements the readily available from various sources, online and elsewhere.

While one case cannot establish association, our case is suggestive of potential dangers of over-the-counter sexual enhancement supplements, which may contain PDE-5 inhibitors, “male hormones,” and “substances that enhance blood production.”

Through this unique case the authors emphasize the need for thorough background information to properly diagnose medical for the best treatment options.

Sufferers of diabetic peripheral neurophathy may find relief with alpha-lipoic acid

pink pills in wrapped

Researchers from the University of Athens found certain doses of alpha-lipoic acid, along with a few other ingredients, helped patients get relief from the discomfort of painful diabetic neuropathy in only 40 days.

An article titled “Effect of α-lipoic acid on symptoms and quality of life in patients with painful diabetic neuropathy,” produced the following impressive results according to the authors.

Out of 72 patients included, significant reductions in neuropathic symptoms were shown by reduced NSS, SPNSQ and DN4 scores at day 40 versus baseline. BPI, NPSI, and SDS in terms of work disability, social life disability, and family life disability scores were also significantly reduced. Moreover, 50% of patients rated their health condition as ‘very much better’ or ‘much better’ following α-lipoic acid administration. Fasting triglyceride levels were reduced, but no difference was found in body weight, blood pressure, fasting glucose, or other lipids at day 40 versus baseline.

Study Procedure

Administered orally at 600 mg/day for 40 days, the compound they gave the subjects was Nevralip Retard®, which is a blend of these nine ingredients:

The entire study consisted of two visits – one to determine the initial values for the data, and the second to gauge the effects of the experiment after 40 days of taking the alpha-lipoic acid blend.

Quick summary of findings

The chart below indicates the majority of the 72 patient’s Quality of Life (QoL) improved across the board after 40 days taking the supplement.

Cautionary note

The scientists noted since no placebos where used could have read the claims by the manufacturer what to expect from the pills.

This was an open-label study, however, without a placebo treatment arm, and as such has inherent limitations, since both the study participants and the health-care providers were aware of the treatment provided. Thus, imagined or random effects of the agent cannot be ruled out. Furthermore, it is unclear if and at what extent the recorded benefits in the present study group would subside after α-lipoic discontinuation.

Concluding remarks

The collaborators made these observations, which summarized what results suggested to them.

In conclusion, the current study suggests that 600 mg/day α-lipoic acid, administered orally for 40 days, to patients with painful diabetic neuropathy, has a clinically significant impact on controlling neuropathy symptoms, fasting triglycerides, and quality of life. Moreover, half of the treated patients rated their health status as ‘much better’ or ‘very much better’ following 40 days of treatment.

Addendum

They noted the substance was provided free-of-charge to the patients, so there is no guarantee the 72 people will continue or can afford taking the dosages after the trial ended. Nor are there any assurances on the long-term benefits of the treatment, since no follow-up visits were scheduled.