Pregabalin serum levels in apprehended drivers

• Pregabalin was often used in high doses by drivers suspected of DUID.
• Poly-drug use was very common.
• Benzodiazepines were the most prevalent co-findings in pregabalin-positive cases.
• The actual effects of pregabalin on driving performance remained unclear.

Pregabalin is a medicinal drug used mainly for the treatment of epilepsy and neuropathic pain. It has been shown to possess an abuse potential and in recent years some reports of illegal use have been published. In order to further evaluate the extent and nature of pregabalin abuse, serum pregabalin levels of drivers apprehended for driving under the influence of drugs (DUID) in Finland in 2012 were assessed. The samples were analysed by an LC–MS/MS system and the results were evaluated in relation to the typical therapeutic range of pregabalin as well as the age and gender of the driver.Pregabalin was detected in 206 samples in the study period. The median (range) serum concentration was 6.2 (0.68–111.6) mg/L. In nearly 50% of the cases the serum concentration was above the typical therapeutic range. In most of the cases the driver had also taken other drugs besides pregabalin, the mean number of concomitantly taken drugs being four.Our data indicate that pregabalin is being used at high doses, probably for recreational purposes. The vast majority of the drivers positive for pregabalin in our study material had used pregabalin as a part of a spectrum of psycho-active drugs and thus qualified as probable drug abusers. In these cases pregabalin probably contributed to their driving impairment but to what extent remained unclear in this study.