{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:29:12Z","timestamp":1787027352683,"version":"build-2736575974"},"reference-count":6,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Toxicol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pregabalin (PGB) is widely used for neuropathic pain, generalized anxiety disorder, and seizure management; however, recent epidemiological data highlight a progressive increase in its misuse and involvement in intoxications, particularly among adolescents and individuals with psychiatric comorbidities. Although dose\u2013toxicity relationships have been explored in adult populations, substantial interindividual variability persists, and data in pediatric or adolescent patients remain limited. Establishing clearer associations between ingested dose, serum concentrations, and clinical severity is essential to guide management strategies and identify cases requiring advanced interventions such as extracorporeal removal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>We describe the case of a 16-year-old girl who intentionally ingested 2,700\u00a0mg (54\u00a0mg\/kg, based on the patient\u2019s body weight of 51\u00a0kg) of immediate-release pregabalin. She presented at the Emergency Care Unit 10\u00a0h after ingestion with marked somnolence, psychomotor slowing, and bilateral horizontal nystagmus, while vital signs, renal and hepatic function tests remained normal. Electrocardiography revealed only mild PR interval prolongation. Serial plasma concentrations of Pregabalin demonstrated a decline from 16.5\u00a0mg\/L at 12\u00a0h to 8.4\u00a0mg\/L at 18\u00a0h and 0.69\u00a0mg\/L at 34\u00a0h, consistent with expected pharmacokinetics. No gastrointestinal decontamination was performed due to delayed presentation, and no extracorporeal treatments were deemed necessary. Patient was subjected to a clinical conservative management, and progressively recovered without neurological sequelae.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite ingestion of a dose commonly associated with moderate to severe toxicity, the patient exhibited a mild and self-limited clinical course, emphasizing the variability of pregabalin toxicity in adolescents. Clinical assessment remains the primary guide, while serum concentrations provide supportive information when available.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/ftox.2026.1822851","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T22:10:14Z","timestamp":1782339014000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Case Report: High-dose pregabalin ingestion in an adolescent: clinical course and serial plasma concentrations"],"prefix":"10.3389","volume":"8","author":[{"given":"Raffaele","family":"Simeoli","sequence":"first","affiliation":[{"name":"Laboratory of Metabolic Diseases and Drug Biology, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Armiento","sequence":"additional","affiliation":[{"name":"Residency School of Pediatrics, University of Rome Tor Vergata","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Cairoli","sequence":"additional","affiliation":[{"name":"Laboratory of Metabolic Diseases and Drug Biology, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mara","family":"Pisani","sequence":"additional","affiliation":[{"name":"Emergency Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Silvestri","sequence":"additional","affiliation":[{"name":"Emergency Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Marano","sequence":"additional","affiliation":[{"name":"Pediatric Poison Control Center, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS","place":["Rome, Italy"]},{"name":"Pediatric Intensive Care Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1053\/j.ajkd.2021.06.027","article-title":"Extracorporeal treatment for Gabapentin and pregabalin poisoning: systematic review and recommendations from the EXTRIP workgroup","volume":"79","author":"Bouchard","year":"2022","journal-title":"Am. J. Kidney Dis."},{"key":"B2","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1111\/1556-4029.13263","article-title":"Determining the toxicological significance of pregabalin in fatalities","volume":"62","author":"Elliott","year":"2017","journal-title":"J. Forensic Sci."},{"key":"B3","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1007\/s40265-020-01432-7","article-title":"Abuse and misuse of pregabalin and Gabapentin: a systematic review update","volume":"81","author":"Evoy","year":"2021","journal-title":"Drugs"},{"key":"B4","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1055\/s-0043-116492","article-title":"Consensus guidelines for therapeutic drug monitoring in neuropsychopharmacology: update 2017","volume":"51","author":"Hiemke","year":"2018","journal-title":"Pharmacopsychiatry"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1288","DOI":"10.1111\/bcp.15073","article-title":"Pregabalin poisoning: evaluation of dose\u2013toxicity relationship","volume":"88","author":"Rietjens","year":"2022","journal-title":"Br. J. Clin. Pharmacol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"69","DOI":"10.2147\/CPAA.S82143","article-title":"Pharmacokinetic equivalence study of two formulations of the anticonvulsant pregabalin","volume":"7","author":"Tjandrawinata","year":"2015","journal-title":"Clin. Pharmacol."}],"container-title":["Frontiers in Toxicology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/ftox.2026.1822851\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T22:10:15Z","timestamp":1782339015000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/ftox.2026.1822851\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,25]]},"references-count":6,"alternative-id":["10.3389\/ftox.2026.1822851"],"URL":"https:\/\/doi.org\/10.3389\/ftox.2026.1822851","relation":{},"ISSN":["2673-3080"],"issn-type":[{"value":"2673-3080","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,25]]},"article-number":"1822851"}}