Association Between Gabapentin Receipt for Any Indication and Alcohol Use Disorders Identification Test—Consumption Scores Among Clinical Subpopulations With and Without Alcohol Use Disorder. (3rd February 2019)

• Record Type: Journal Article
• Authors: Rentsch, Christopher T.; Fiellin, David A.; Bryant, Kendall J.; Justice, Amy C.; Tate, Janet P.
• Is Part Of: Alcoholism. Volume 43:Number 3(2019)
• Page Start: 522
• Page End: 530
• Publication Date: 2019-02-03
• Subjects: Gabapentin -- Alcohol Use Disorder -- Electronic Health Records -- Propensity Score; Alcoholism -- Periodicals; Alcoholism -- Periodicals; Alcoolisme; Electronic journals; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.861005
• DOI: 10.1111/acer.13953
• Languages: English
• ISSNs: 0145-6008

Abstract

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 5 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% confidence interval [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 mg/d (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/d 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. Abstract : Among non‐treatment seeking individuals with alcohol use disorder (AUD), AUDIT‐C scores decreased 0.4 more points among those prescribed gabapentin, for any reason, than controls not prescribed gabapentin ( p = 0.03). The clinical significance of this change is not known. In stratified analyses by AUD history, baseline AUDIT‐C, and dose, patients prescribed higher doses of gabapentin, particularly those with AUD, experienced greater decreases in AUDIT‐C scores. Among patients without AUD, we found no overall difference in AUDIT‐C score changes.