Gabapentinoid Dispensing to Children and Adolescents in the U.S.

Abstract

Introduction: Gabapentin and pregabalin (gabapentinoids) are increasingly prescribed to children and adolescents off label for various conditions despite limited data and concerns for adverse outcomes including misuse and overdose. The extent of gabapentinoid use in children and adolescents is unknown.

Methods: Nationally representative retail pharmacy dispensing data from IQVIA was used to describe trends in gabapentinoid dispensing to children and adolescents aged ≤19 years from April 2017 through September 2023. The analysis was performed in 2024. Trends by patient age and sex and by prescriber specialty are presented along with median quarterly rates (MQR) and quarterly percentage changes (QPC).

Results: Over the study period, the gabapentinoid dispensing rate was 4534.9/100,000 individuals. The MQR was 168.9/100,000. Between Q2 2017 and Q2 2021, the QPC was not significant (QPC=0.08; 95% CI= -2.9, 0.8) but became significant between Q2 2021 and Q3 2023 (QPC=2.8; 95% CI=1.2, 8.4). Dispensing rates were highest for adolescents aged 10-19 years (MQR=267.3/100,000) and females (MQR=187.6/100,000). Nurse practitioners prescribed the highest percent of gabapentinoids dispensed (17.8%). The total number of gabapentinoids dispensed increased from 2018 to 2022 across all specialties except psychiatry (-14.8%) and internal medicine (-9.2%), with nurse practitioners (48.2%), surgical specialists (48.0%), and addiction medicine specialists (51.2%) representing the largest increases.

Conclusions: Gabapentinoid receipt among U.S. children and adolescents has increased. Future research can explore factors associated with prescribing including changing epidemiology of pain and psychiatric diagnoses in children and adolescents. Prescribing clinicians should carefully consider the potential risks and benefits of gabapentinoids in clinical practice.