Niti G. Patel MD, PharmD, David Goese MD, Steven M. Belknap MD, Charles L. Madeira MD, Jeffrey H. Barsuk MD, MS
{"title":"Things We Do for No Reason™: Prescribing gabapentinoids for pain","authors":"Niti G. Patel MD, PharmD, David Goese MD, Steven M. Belknap MD, Charles L. Madeira MD, Jeffrey H. Barsuk MD, MS","doi":"10.1002/jhm.70286","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n <p>Gabapentin and pregabalin are among the most frequently prescribed medications in the United States, with gabapentin in the top 10 and pregabalin in the top 100. Despite FDA approval for only select neuropathic conditions, most use is for off-label pain indications. Randomized trials show minimal or clinically insignificant benefit for most off-label pain syndromes. In contrast, gabapentinoids are associated with sedation, falls, delirium, respiratory depression, misuse, and hospitalization, especially with opioids or renal impairment. Given limited efficacy and harms, they should not routinely substitute for opioids. Clinicians should reassess indications, deprescribe when appropriate, and prioritize nonpharmacologic strategies.</p>\n </section>\n </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"21 6","pages":"670-676"},"PeriodicalIF":1.8000,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.70286","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of hospital medicine","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/jhm.70286","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/2/15 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Gabapentin and pregabalin are among the most frequently prescribed medications in the United States, with gabapentin in the top 10 and pregabalin in the top 100. Despite FDA approval for only select neuropathic conditions, most use is for off-label pain indications. Randomized trials show minimal or clinically insignificant benefit for most off-label pain syndromes. In contrast, gabapentinoids are associated with sedation, falls, delirium, respiratory depression, misuse, and hospitalization, especially with opioids or renal impairment. Given limited efficacy and harms, they should not routinely substitute for opioids. Clinicians should reassess indications, deprescribe when appropriate, and prioritize nonpharmacologic strategies.
期刊介绍：
JHM is a peer-reviewed publication of the Society of Hospital Medicine and is published 12 times per year. JHM publishes manuscripts that address the care of hospitalized adults or children.
Broad areas of interest include (1) Treatments for common inpatient conditions; (2) Approaches to improving perioperative care; (3) Improving care for hospitalized patients with geriatric or pediatric vulnerabilities (such as mobility problems, or those with complex longitudinal care); (4) Evaluation of innovative healthcare delivery or educational models; (5) Approaches to improving the quality, safety, and value of healthcare across the acute- and postacute-continuum of care; and (6) Evaluation of policy and payment changes that affect hospital and postacute care.
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