Anticonvulsant Addiction

Anticonvulsants are widely prescribed medications for the management of different neurological conditions. While they can be potentially life-changing for sufferers, their potential for misuse means that following prescription guidelines is crucial for safe and effective use. Anticonvulsant addiction, though less commonly discussed than other forms of drug addiction, can be an incredibly damaging condition both for those affected and their loved ones.

What are anticonvulsants?

Anticonvulsants, also known as anti-seizure medications, are drugs that are primarily used to control seizures in conditions like epilepsy. They work by stabilising electrical activity in the brain, preventing the rapid firing of neurons that cause seizures. In addition to epilepsy, some anticonvulsants are also used to treat anxiety, manage pain from nerve damage and help with bipolar disorder symptoms by dampening mood swings.

What is anticonvulsant addiction?

Anticonvulsant addiction is defined as compulsive drug seeking and use despite harmful consequences. As with many other forms of prescription drug addiction, an addiction to anticonvulsants often develops when the medications are not used as prescribed. This may mean chasing a pleasure high or feeling of sedation, taking high doses for increased effects or self-medicating for some underlying issue that is causing distress or unhappiness.

Whatever the original reason for misuse, over time, some people may develop a tolerance to the effects, leading them to increase their dosage further. This escalated use can quickly become what is known as “physical dependence”, where the body adapts to the drug’s presence, and you experience withdrawal symptoms if you stop taking it. When there is also a psychological dependence – such as needing the drug to cope with life’s challenges – a full-blown anticonvulsant addiction is firmly in place.
Two of the most common forms include:

Gabapentin addiction
Gabapentin is often prescribed off-label for anxiety and other conditions but is commonly misused. People may start to take higher doses than prescribed to amplify its calming effect, leading to de…

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Pregabalin addiction
Pregabalin can create a state of relaxation and well-being that may be abused, especially in individuals looking for relief from stress or anxiety. Over time, this can lead to a cycle of dependency…

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Anticonvulsant addiction in the UK

In the UK, anticonvulsants have been the subject of increased concern over recent years, with Gabapentin and Pregabalin being particularly concerned for healthcare and legal authorities. Instances of drug-related deaths, often due to a mixture of Gabapentin and Pregabalin with opioids, increased dramatically during the 2010s, and this saw them reclassified as Class C controlled substances in April 2019.

Despite this reclassification, however, deaths have continued to rise, with 133 deaths due to Gabapentin in 2021 and 779 deaths due to Pregabalin in 2022. The Pregabalin numbers are particularly shocking when you consider that there were only nine fatalities in 2012. This is the biggest rate increase for any prescription drug and underscores the need for caution from both users and prescribers.

How to spot anticonvulsant addiction symptoms

The development of anticonvulsant addiction can be insidious, with many people not realising they are addicted until they are suddenly faced with serious health or social consequences. Some key anticonvulsant addiction symptoms to look out for include:

  • Needing more of the anticonvulsant to feel its effects, whether that’s controlling seizures, managing pain or lessening anxiety.
  • Experiencing withdrawal symptoms if you miss a dose or try to stop taking anticonvulsants.
  • Feeling chronically fatigued and finding it hard to stay awake.
  • Taking anticonvulsants more often or in bigger doses than prescribed.
  • Trying and failing to cut back
  • Going to several doctors to try and get more prescriptions.
  • Missing out on work, school or social life because you are focused on anticonvulsants.
  • Using anticonvulsants to get high or experience some other pleasant effects.
  • Still taking anticonvulsants even though they are causing these problems.

Identifying these anticonvulsant addiction symptoms can be the difference between getting the right help before things spiral out of control.

What can lead to anticonvulsant addiction?

Understanding the factors that increase the risk of developing an addiction to anticonvulsants is very important for prevention and devising effective treatment. Here are some key risk factors that can make someone more susceptible:

 

Chronic prescriptions
Long-term use of anticonvulsants for chronic conditions like epilepsy or persistent neuropathic pain can inadvertently lead to dependence as the body adapts to the presence of the drug.
History of substance abuse
Individuals with a history of substance abuse are more prone to misuse medications, including anticonvulsants, often due to a genetic predisposition toward addictive behaviours.
Psychiatric conditions
Those with mental health disorders such as anxiety or depression may misuse their anticonvulsant medications to alleviate their symptoms, which can lead to addiction.
Lack of monitoring
Insufficient oversight by a doctor can lead to inappropriate dosages or prolonged use, increasing the risk of addiction.
Accessibility and misinformation
Easy access to prescriptions or misinformation about the addictive potential of anticonvulsants can also contribute to the development of an addiction.

Why is anticonvulsant addiction so dangerous?

Anticonvulsant addiction can have serious implications for both physical and mental health and every other aspect of your life:

Physical health risks

  • Seizure risk: Misusing anticonvulsants, even those prescribed for seizures, can actually lead to an increase in seizures. This is a particular danger if the drug is stopped suddenly.
  • Liver damage: Some anticonvulsants can be hard on the liver and misuse can exacerbate this effect, potentially leading to liver failure.
  • Drug interactions: Anticonvulsants can interact dangerously with other medications, illicit drugs and alcohol, which is particularly risky without professional oversight.
  • Increased sensitivity to pain: With drugs like gabapentin and pregabalin, which are used to treat neuropathic pain, misuse can lead to heightened pain sensitivity or hyperalgesia when the drug is reduced or withdrawn.

Mental health risks

  • Cognitive decline: Long-term misuse of anticonvulsants can lead to problems with memory, attention and other cognitive functions.
  • Mood disturbances: Anticonvulsants can affect neurotransmitter levels in the brain, leading to mood swings, depression and anxiety.
  • Mental health decline: Anticonvulsant addiction can both trigger new mental health issues and exacerbate underlying ones.

Social and occupational consequences

Anticonvulsant addiction can lead to difficulties in maintaining relationships, job responsibilities and social obligations, all of which can make the health consequences even worse and lead to a variety of financial and personal issues.

Treatment for anticonvulsant addiction

Treating anticonvulsant addiction involves several critical steps designed to ensure safety and foster long-term recovery. The initial step is a medically guided detox to disrupt the physical reliance on anticonvulsants. The detox process may involve gradually reducing the dosage or using substitute medications to mitigate withdrawal symptoms.

After detox, anticonvulsant rehab then focuses on understanding why and how the person became addicted and the steps they need to take to change their lives. Like all forms of prescription drug rehab, this usually involves a range of different therapies and other treatments and can be provided on either an outpatient or inpatient basis.

Relapse prevention and aftercare make up the final post-rehab stage. They help ensure that the person doesn’t return to using anticonvulsants after their treatment is finished. Relapse prevention strategies include ongoing therapy, creating strategies to handle cravings and joining a support group like Narcotics Anonymous.

How to get help for anticonvulsant addiction

If you or someone you know is struggling with anticonvulsant addiction, it is important to seek help immediately. Start by contacting us to find out more about how rehab can help you fight back from anticonvulsant addiction.
 

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FAQ’s

Can anticonvulsant addiction lead to overdose?
Yes, anticonvulsant abuse and addiction can cause overdose with severe consequences, including respiratory failure, coma and death. Pregabalin and similar drugs are especially dangerous when taken in large quantities or when combined with other substances like opioids, alcohol or other depressants, which can exacerbate their effects.

(Click here to see works cited)

  • Forsyth, Laura. “’Anxiety drug’ pregabalin addiction surge sparks pleas for mental health support.” City A.M., 19 March 2024, https://www.cityam.com/anxiety-drug-pregabalin-addiction-surge-sparks-pleas-for-mental-health-support/. Accessed 12 May 2024.
  • Horowitz, Mark. “⁠⁠’If I miss a dose I have trouble breathing’: Anti-anxiety drug Pregabalin causes concern in the UK.” Euronews.com, 7 March 2024, https://www.euronews.com/health/2024/03/07/if-i-miss-a-dose-i-have-trouble-breathing-anti-anxiety-drug-pregabalin-causes-concern-in-t. Accessed 12 May 2024.
  • NHS. “Pregabalin: medicine to treat epilepsy and anxiety.” NHS, https://www.nhs.uk/medicines/pregabalin/. Accessed 12 May 2024.
  • Kalk, Nicola J., et al. “Fatalities Associated with Gabapentinoids in England (2004–2020).” British Journal of Clinical Pharmacology, vol. 88, no. 8, 2022, pp. 3911-3917, https://doi.org/10.1111/bcp.15352. Accessed 12 May 2024.