Functional Impairment and Cognitive Symptoms Among People with HIV Infection on Chronic Opioid Therapy for Pain: The Impact of Gabapentin and Other Sedating Medications

AIDS Behav. 2022 Dec;26(12):3889-3896. doi: 10.1007/s10461-022-03716-3. Epub 2022 Jun 23.

Abstract

Gabapentin is associated with dizziness, falls, and somnolence yet commonly prescribed to people with HIV (PWH) treated with chronic opioid therapy (COT). Physical function and cognition are understudied when prescribed together. Among PWH on COT, we evaluated whether co-prescribed gabapentin is associated with (a) functional impairment; (b) trouble thinking clearly; and (c) difficulty controlling drowsiness using logistic regression models adjusted for prescribed opioid dose, other (non-gabapentin) sedating medication, substance use disorder, and mental/physical health indicators in a cross-sectional study. Among 166 participants, 40% were prescribed gabapentin, 41% reported functional impairment, 41% trouble thinking clearly, and 38% difficulty controlling drowsiness. Gabapentin co-prescribed with COT was significantly associated with trouble thinking clearly but not with functional impairment or difficulty controlling drowsiness. Clinicians should be cognizant of potential problems with thinking clearly when co-prescribing gabapentin and opioid medication.

Keywords: Chronic opioid treatment; Chronic pain; Cognition; HIV; Sedatives.

MeSH terms

  • Analgesics, Opioid / adverse effects
  • Chronic Pain* / drug therapy
  • Cognition
  • Cross-Sectional Studies
  • Gabapentin / therapeutic use
  • HIV Infections* / complications
  • HIV Infections* / drug therapy
  • HIV Infections* / psychology
  • Humans
  • Pain / drug therapy

Substances

  • Analgesics, Opioid
  • Gabapentin