In 2019, the FDA issued a warning about serious breathing problems with seizure and nerve pain medicines gabapentin and pregabalin when used with CNS depressants or in patients with lung problems. Gabapentin and pregabalin are FDA-approved for a variety of conditions, including seizures, nerve pain, and restless legs syndrome.

Even with this warning, a recent study found that use of gabapentin has increased from 4% of the population in 2015 to 4.7% in 2021, and in many cases the drug is prescribed off label for chronic pain conditions where little evidence supports the use. That said, between 2017 and 2021, most patients using gabapentin reported having musculoskeletal pain and diabetes. Why is this a concern? The use of this medication is common among patients taking other classes of medications that act on the central nervous system, i.e., sedating medications. The FDA warns that co-prescribing gabapentin with other central nervous system depressants can cause life-threatening breathing difficulties.

Many times, medications are not effective, but we continue to administer them as ordered. Why? Do you have a process for assessing residents receiving these medications? Are you asking the question “does this medication help with your pain”? Are your attending physicians actively involved? Maybe it is time to schedule a ‘pow-wow’ with the Medical Director and Pharmacy to discuss opportunities for preventing negative outcomes and possibly decrease the use of medications that may increase risk to your residents. If researchers are raising the flag, it is important enough to do something about it! Stay well and stay informed!