Anxiety drugs widely prescribed in the UK linked to 26% rise in suicide risk, study shows

‘Young people at greatest risk’ as millions of prescriptions of pregabalin, dubbed ‘new valium’, and other gabapentinoids issued annually

Overdose risks when combined with other substances have led to gabapentinoids being rescheduled as class C drugs (Rex)

People taking a widely used class of medication prescribed for anxiety, nerve pain or epilepsy are up to 26 per cent more likely to die by suicide, a study has warned.

British researchers, led by Oxford University, have called for a review on the use of gabapentinoid drugs in treating young people after finding risks were particularly high among 15- to 24-year-olds.

In addition to suicidal behaviours, rates of being involved in a car crash or traffic offence, of sustaining a physical injury and of accidental overdose were all raised when people were being treated with gabapentinoids, the study found.

Gabapentinoid prescriptions have trebled in the UK since 2007 – with around 3 per cent of the population having been put on the drugs over the past decade. There are currently 10 million prescriptions being dispensed in England and Wales alone. All of which contribute towards gabapentinoids being among the top 15 most valuable drugs to the global pharmaceutical industry.

However, growing concern about their potential for harm and abuse saw the most commonly prescribed gabapentinoids, pregabalin (dubbed the “new valium”) and gabapentin, reclassified as a class C-controlled drug in April 2019.

The latest study, published in The BMJ, used health and criminal records from 192,000 Swedish citizens between 2006 and 2013 who were treated with pregabalin or gabapentin. Around 10,000 participants (5 per cent) were treated for suicidal behaviour, or died by suicide during this time, while 17,000 (9 per cent) unintended overdoses were recorded.

Suicidal behaviour and deaths rose by a quarter while people were taking a prescribed gabapentinoid, while unintentional overdoses were 24 per cent higher, head and body injuries were 22 per cent higher, and traffic incidents and offences were 13 per cent higher. Older age groups showed higher risks for some of these factors, but among younger people the risks were raised across all potential harms and were particularly high for suicidal behaviour and unintended overdose.

The Oxford University researchers said this may be because they are more likely to combine their prescription with alcohol and illegal substances. There is also some suggestion they may be more vulnerable to emotional and psychological side effects which can be part of withdrawal symptoms.

“This is the biggest study in the real world of the pattern of gabapentinoid use,” Professor Seena Fazel, a forensic psychiatrist at Oxford University and lead author of the study, told The Independent. “The main thing is to look at guidelines now and see if they’re consistent with the evidence [of these risks].” If not then they may need to be reviewed to protect these high-risk groups, he added.

The findings come as experts called for ministers to declare opioid overdose deaths a “public health crisis”, and gabapentinoids may be one of the factors behind the increase.

Dr Derek Tracey, a consultant psychiatrist at Queen Mary’s Hospital in London, said the reclassification of gabapentinoids as restricted drugs may make GPs more reluctant to prescribe them.

“Despite reasonable concerns, gabapentinoids remain a valued therapeutic option for many people,” he said in The BMJ. “Medicines can harm as well as heal, and the best treatment decisions are made in full partnership with patients, after consideration of all available evidence on both.”

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