Hooked on anxiety drugs
In 2018, there were almost six million prescriptions written for pills now known to cause dependency. Writer Miranda Levy, 51, investigates a growing scandal which has blighted her own life
THE other day, I went out for dinner with an old friend. At about 9pm I started to feel queasy and hot. Too soon for food poisoning. Had I drunk my (single) gin and tonic a bit too quickly?
I stood to head for the bathroom and was hit by a wave of dizziness. Once in the cubicle, I thought I was going to be sick. Did I have a bug, perhaps? Then I realised – it had to be withdrawal symptoms from my pregabalin.
I was prescribed this “antianxiety” pill by my psychiatrist about four years ago, while suffering from severe insomnia caused by my marriage breakdown.
Back then, I hadn’t heard of it, but today some experts are calling it “the new Valium” because of the risk of dependency and withdrawal symptoms.
Although I have been well for a while, I have been trying to wean myself off the drug, also known as Lyrica, for nine months.
Using a programme structured by a psychiatrist, I’ve cut back my daily dose but I’m still struggling to completely come off a drug which, arguably, I shouldn’t have been given in the first place. I’m not alone either – millions are in the same boat. What is pregabalin? A member of the class of drugs called gabapentinoids, it was licensed first in 2004 for epilepsy, then for neuropathic or nerve pain. In the past decade, specialists started to prescribe it
“offlabel” (a secondary use) for anxiety. Not much was said about this until last September, when pregabalin was included in a wider story about prescription pill addiction.
Public Health England had asked the government to help people whose lives have been blighted by five classes of prescription drugs including sleeping pills, antidepressants and gabapentinoids such as pregabalin.
The measures included plans for a 24-hour helpline, tougher guidelines on prescribing and acknowledged ( for the first time) that withdrawal from these drugs can cause health problems.
Yet prescriptions for gabapentinoids (which also include the painkiller gabapentin) have risen 71 per cent since 2013/14, with almost six million prescriptions being issued to people in 2018.
Pharmaceutical corporation Pfizer, who manufacture Lyrica (pregabalin), said: “When prescribed and administered appropriately, Lyrica (pregabalin) is an important and effective treatment for many living with chronic neuropathic pain, generalised anxiety disorder and epilepsy. The clinical effectiveness of this medicine has been demonstrated in a large number of clinical trials among thousands living with the conditions.” Ignored warnings A few doctors have been warning about pregabalin for some time. Dr Peter Gordon is a just-retired consultant psychiatrist from the Forth Valley in Scotland. He has been writing about problems with mood-altering drugs for several years. “Pregabalin is prescribed for anxiety despite the NHS knowing about the harmful effects it has had in the US,” he said. Glasgow GP Peter Spence has also written about pregabalin in his Bad Medicine column in the British Medical Journal. In a 2013 column, he said: “There is increasing evidence of concern about the abuse of pregabalin and gabapentin. Increasingly, I confront drug-seeking behaviours. Could it be these seemingly harmless epilepsy drugs are being misused?” Dr Spence went on to tell how users described great euphoria and opiate buzzes from taking them. “There is a growing black market and these drugs are being bought through online pharmacies,” he wrote.
Spence was writing specifically about abuse by recreational drug users, rather than patients prescribed the tablets by their doctors. But it has the same effects either way.
Last April, about two-and-a-half years after I started taking pregabalin, it was reclassified as a Class C controlled substance in the UK.
This was on the back of publicity about how it was abused recreationally in prisons, had become a problem in parts of Northern Ireland and had led to several deaths. The reclassification made it illegal for GPs to supply pregabalin and gabapentin through automatic repeat prescriptions. Doctors now have to hand-sign them.
Manufacturers Pfizer added: “Patient safety is, and will always be, Pfizer’s utmost priority. We work with regulatory authorities around the world to continuously evaluate and monitor safety for each and every Pfizer medicine through ongoing clinical research, analysis and surveillance.”
But in the past few months there has been more talk from medics describing pregabalin as the “new Valium” (an addictive tranquilliser).
Psychopharmacologist David Healy, a professor of psychiatry at Bangor University, said: “I would rather call it Valium on steroids. In fact, I would prefer to take Valium, it’s easier to get off.”
Despite this, pregabalin prescriptions are still being written.
There is a black market and the drugs are bought via online pharmacies