The Lethal Combination of Pregabalin With Other Recreational Drugs.
Alison Muñoz, Marai Roque, Marco Valladares, Kim Nguyen, Eric Tran, Guinda St Fleur, Lorraine Mukona, Nadia Yar, Mohammed Siddiqui
Cureus April 1, 2025 DOI: 10.7759/cureus.81675 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | 33-year-old male with multidrug abuse |
| Topics | Ketamine |
| Keywords | Delusions Drug abuse Lyrica Recreational drugs Drug interactions Drug misuse Neurotoxicity toxic encephalopathy Brain toxicity Pregabalin abuse Polysubstance use |
| Key findings | Self-medicating with pregabalin alongside other neuroactive substances can lead to severe toxic-metabolic encephalopathy and acute kidney injury. |
Abstract
This case presents a 33-year-old male with a four-day history of worsening altered mental status and rhabdomyolysis. He experienced delusions, restlessness, and visual hallucinations, exacerbated by prolonged multidrug abuse, including over-the-counter pregabalin (Lyrica) for pain relief and recreational ketamine. Despite an initially incomplete history and unclear etiology, the patient was admitted for toxic-metabolic encephalopathy with acute kidney injury (AKI) and required significant medical management for confusion, acidosis, and electrolyte disturbances. This patient's severe presentation serves as a caution against self-medicating with neuromodulators like pregabalin, especially alongside current or historical misuse of other neuroactive substances. This case affirms the necessity of swiftly discerning both clinical symptoms and psychiatric risk factors in the effective identification and treatment of dangerous pregabalin intoxication.
Comparable studies
Other case reports and case series on ketamine, most cited first.