Study of Acute Pregabalin Intoxication in Patients Admitted to Poison Control Center Ain Shams University Hospitals and its Pathological Effect on Rat Brain: Clinical and Experimental Study

Lasheen, Dalia; Sherif, Nahla; El-Taftazani, Enas; Atalla, Suzi; Abdellkader, Salma I.

doi:10.21608/ajfm.2023.285281

Study of Acute Pregabalin Intoxication in Patients Admitted to Poison Control Center Ain Shams University Hospitals and its Pathological Effect on Rat Brain: Clinical and Experimental Study

Document Type : Original Article

Authors

¹ Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

² Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

³ Histology and cell biology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

10.21608/ajfm.2023.285281

Abstract

Background: Pregabalin (PGB) has been an anti-epileptic and an effective treatment of
neuropathic pain; it acts by inhibiting certain presynaptic calcium channels and decreased
excitatory neurotransmitters. There are reported serious effects following PGB exposure beside
its addictive effect. Aim of the work: Study the pattern of acute PGB toxicity in patients
admitted to Poison Control Center-Ain Shams University Hospitals (PCCASUH) and its
histopathological effects after acute toxic dose in adult albino rat brain.
Methods: The study was comprised of two parts. The clinical part: on 31 patients admitted to
PCCASUH with a history of acute PGB toxicity. The experimental part: on thirty adult albino
rats, divided into two groups (acute toxicity group received acute single dose of PGB5000 mg/kg
and the control group received normal saline). Results: Acute PGB exposure leads to mild
toxicity and most of symptoms related to CNS included DCL, with a significant relation between
the prolonged period of hospital admission and the DCL. The experimental results revealed that
the cerebral cortex (CC) and cerebellum showed degeneration of nerve cells, pyknosis with
karyolysis of nuclei, and a marked increase in the glial cells with positive glial fibrillary acidic
protein (GFAP) cytoplasmic granules in the CC (toxic group). Conclusion: The course of PGB
intoxication is mostly mild self-limiting and most of patients discharged on the next day of
admission. The experimental study concluded that PGB has degenerative effects on brain nerve
cells. Recommendations: further studies with larger sample size to evaluate the acute and
chronic toxicity of PGB.
Received in original form: 15 January 2023 Accepted in final form: 31 January 2023

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