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Alcohol Clin Exp Res. 2019 Jan 8. doi: 10.1111/acer.13953. [Epub ahead of print]

Association between gabapentin receipt for any indication and AUDIT-C scores among clinical sub-populations with and without alcohol use disorder.

Author information

1
Veterans Aging Cohort Study Coordinating Center, VA Connecticut Healthcare System, West Haven, CT, 06516, USA.
2
Department of Internal Medicine, Yale School of Medicine, New Haven, CT, 06511, USA.
3
Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK.
4
Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, CT, 06511, USA.
5
Director of HIV/AIDS Research, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, 20892, USA.

Abstract

BACKGROUND:

Current medications for alcohol use disorder (AUD) have limited efficacy and utilization. Some clinical trials have shown efficacy for gabapentin among treatment-seeking individuals. The impact of gabapentin on alcohol consumption in a more general sample remains unknown.

METHODS:

We identified patients prescribed gabapentin for ≥180 consecutive days for any clinical indication other than substance use treatment between 2009 and 2015 in the Veterans Aging Cohort Study. We propensity-score matched each gabapentin exposed patient with up to five unexposed patients. Multivariable difference-in-difference (DiD) linear regression models estimated the differential change in Alcohol Use Disorders Identification Test - Consumption (AUDIT-C) scores during follow-up between exposed and unexposed patients, by baseline level of alcohol consumption, and daily gabapentin dose. Analyses were stratified by AUD history. Clinically meaningful changes were a priori considered a DiD ≥1 point.

RESULTS:

Among patients with AUD, AUDIT-C scores decreased 0.39 points (95% CI 0.05, 0.73) more among exposed than unexposed patients (p<0.03). Potentially clinically meaningful differences were observed among those with AUD and exposed to ≥1,500 milligrams/day (DiD 0.77, 95% CI 0.15, 1.38; p<0.02). No statistically significant effects were found among patients with AUD at doses lower than 1,500 mg/day or baseline AUDIT-C ≥4. Among patients without AUD, we found no overall difference in changes in AUDIT-C scores, nor in analyses stratified by baseline level of alcohol consumption.

CONCLUSIONS:

Patients exposed to doses of gabapentin consistent with those used in clinical trials, particularly those with AUD, experienced a greater decrease in AUDIT-C scores than matched unexposed patients. This article is protected by copyright. All rights reserved.

KEYWORDS:

alcohol use disorder; electronic health records; gabapentin; propensity score

PMID:
30620410
DOI:
10.1111/acer.13953

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