Talk Evidence
Gabapentinoid pain meds linked to self-harm, and getting to the Core of GRADE
23 Jun 2025
Helen MacDonald and Juan Franco are back to examine the newest in evidence based medicine. In this episode: gabapentinoids are medications routinely prescribed for treating epilepsy and nerve pain. But, they come with side effects; among them - dizziness, cognitive impairment, and a dent to motor coordination - as well as an increase in suicidal ideation for the patient. Seena Fazel is professor of forensic psychiatry at University of Oxford and joins Juan to discuss a new paper tracking the association of self-harm and gabapentinoids use in Sweden. Meanwhile, GRADE is a fundamental tool for clinicians to assess the quality of evidence for medical interventions. But, the sheer number of recommendations in the GRADE series can be overwhelming. Gordon Guyatt is a distinguished professor of medicine at McMaster University in Canada, and an early figure in the rise of evidence based medicine. He joins Helen to reflect on the future of EBM, and how the new Core GRADE system can cut through the noise. Reading list: 1. Associations between gabapentinoids and suicidal behaviour, unintentional overdoses, injuries, road traffic incidents, and violent crime: population based cohort study in Sweden 2. Why Core GRADE is needed: introduction to a new series in The BMJ
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