The Lethal Combination of Pregabalin With Other Recreational Drugs.

A 33-year-old man with a four-day history of worsening confusion, restlessness, and visual hallucinations was hospitalized. He had been misusing pregabalin (Lyrica) for pain relief and also using recreational ketamine. The patient developed toxic-metabolic encephalopathy (brain dysfunction) and acute kidney injury, requiring treatment for confusion, acidosis, and electrolyte imbalances. The severe presentation warns against self-medicating with neuromodulators like pregabalin, especially when combined with other neuroactive substances. The case underscores the need to quickly identify both clinical symptoms and psychiatric risk factors to effectively diagnose and treat dangerous pregabalin intoxication.

Study at a glance

Abstract

This case presents a 33-year-old male with a four-day history of worsening altered mental status and rhabdomyolysis. He experienced delusions, restlessness, and visual hallucinations, exacerbated by prolonged multidrug abuse, including over-the-counter pregabalin (Lyrica) for pain relief and recreational ketamine. Despite an initially incomplete history and unclear etiology, the patient was admitted for toxic-metabolic encephalopathy with acute kidney injury (AKI) and required significant medical management for confusion, acidosis, and electrolyte disturbances. This patient's severe presentation serves as a caution against self-medicating with neuromodulators like pregabalin, especially alongside current or historical misuse of other neuroactive substances. This case affirms the necessity of swiftly discerning both clinical symptoms and psychiatric risk factors in the effective identification and treatment of dangerous pregabalin intoxication.