Čes. slov. farm. 2025, 74(3):152-156 | DOI: 10.36290/csf.2025.027
Medications with dependence potential: Pharmacological aspects and clinical practise
- Oddělení klinické farmacie, Psychiatrická nemocnice Bohnice, Praha
- Katedra sociální a klinické farmacie, Univerzita Karlova, Hradec Králové
The abuse of medications represents a serious and ongoing public health concern. It has extensive consequences for individuals in the form of deteriorating physical and mental health, while also imposing a significant socioeconomic burden on society.
This article focuses on the pharmacological aspects of medications associated with the development of substance dependence, with particular emphasis on sedatives, hypnotics, opioid analgesics, stimulants, gabapentinoids, and selected over-the-counter preparations. The development of dependence results from a complex interaction of various risk factors and is primarily influenced by the pharmacokinetic and pharmacodynamic properties of substances, individual predispositions, and environmental factors. The aim of this article is to summarize the main mechanisms contributing to the development of substance dependence, describe the pharmacological characteristics of the most commonly abused medication groups, and propose basic recommendations for their rational prescription and for the prevention of dependence. Education of patients and healthcare professionals, including pharmacists, plays a key role in addressing this undesirable phenomenon.
Keywords: medications with addiction potential, addiction, benzodiazepines, opioids, over-the-counter drugs.
Accepted: September 15, 2025; Published: October 2, 2025 Show citation
References
- Chomynová P, Dvořáková Z, Grohmannová K, et al. Souhrnná zpráva o závislostech v České republice 2023. Úřad vlády České republiky; 2024 [Internet]. [cited 15. 5. 2025]. Available from: https://www.drogy-info.cz/publikace/vyrocni-zpravy/souhrnna-zprava-o-zavislostech-v-ceske-republice-2023/.
- Chomynová P, Grohmannová K, Dvořáková Z, et al. Zpráva o problematickém užívání psychoaktivních léčivoů v České republice 2023. Úřad vlády České republiky; 2023 [Internet]. [cited 15. 5. 2025]. Available from: https://www.drogy-info.cz/publikace/vyrocni-zpravy/zprava-o-problematickem-uzivani-psychoaktivnich-leku-v-ceske-republice-2023/.
- Zákon č. 378/2007 Sb., o léčivech a o změnách některých souvisejících zákonů (zákon o léčivech), ve znění pozdějších předpisů.
- Nutt D. Addiction. Oxford Psychiatr Libr. 2013. Oxford: Oxford University Press;2013 (Oxford Psychiatry Library).
- Cea Calvo L, Marín Jiménez I, de Toro J, et al. Different Associations of Intentional and Non Intentional Non Adherence Behaviors with Patient Experience with Healthcare and Patient Beliefs in Medications: A Survey of Patients with Chronic Conditions. Patient Prefer Adherence. 2020;14:2439-2450.
Go to original source...
- Cummins Beebee PN, Chvilicek MM, Rothenfluh A. The Stage Based Model of Addiction - Using Drosophila to Investigate Alcohol and Psychostimulant Responses. Int J Mol Sci. 2023;24(13):10909.
Go to original source...
- Substance Abuse and Mental Health Services Administration (US), Office of the Surgeon General (US). Facing addiction in America: the Surgeon General's report on alcohol, drugs, and health. US Department of Health and Human Services; 2016 [Internet]. [cited 2025 04 26]. Available from: https://addiction.surgeongeneral.gov/.
- Bečková I, Višňovský P. Farmakologie drogových závislostí. Praha: Karolinum; 1999.
- Salzman C, Shader RI, Rosenberg R, et al. Benzodiazepine Dependence, Toxicity, and Abuse: A Task Force Report of the American Psychiatric Association. Washington, DC: American Psychiatric Association; 1990.
- Mravčík V. Substituční léčba závislosti na opioidech v ČR: Kritický pohled. Ces Slov Psychiatr. 2019;115(2):53-58.
- Zhong G, Wang Y, Zhang Y, et al. Association between Benzodiazepine Use and Dementia: A Meta Analysis. PLoS One. 2015 May 27;10(5):e0127836.
Go to original source...
- S3 Leitlinie "Demenzen" (Langversion - Januar 2016). [Internet]. [cited 15.5. 2025]. Available from: https://dnvp9c1uo2095.cloudfront.net/cms-content/S3-Leitlinie_Demenzen_Langversion_2023_11_28_Final_1701248604534.pdf.
- Wu CC, Liao MH, Su CH, et al. Benzodiazepine Use and the Risk of Dementia in the Elderly Population: An Umbrella Review of Meta Analyses. J Pers Med. 2023 Oct 12;13(10):1485.
Go to original source...
- Oulis P, Konstantakopoulos G. Pregabalin in the Treatment of Alcohol and Benzodiazepines Dependence. CNS Neurosci Ther. 2010;16:45-50.
Go to original source...
- Park TW. Benzodiazepine use withdrawal. UpToDate [Internet]. UpToDate; 2024 [cited 2024 04 26]. Available from: www.uptodate.com.
- Chval J. Závislost na zolpidemu. Psychiatr pro Praxi, 2009;10(5):239-240.
- SPC léčivého přípravku Hypnogen. [Internet]. [cited 2025- 05-20]. Available from: www.sukl.cz.
- SPC léčivého přípravku Zopitin. [Internet]. [cited 2025-05-20]. Available from: www.sukl.cz.
- Blažejovský J. Výroba syntetických drog v České republice. Psychológia, teória a prax. 2015;3(3):7 13. [Internet]. Available from: https://proflib.akademiapz.sk/webisnt/fulltext/clanky/PTaP2015-3/002%20%20BLA%C5%BDEJOVSK%C3%9D%20%20V%C3%BDroba%20syntetick%C3%BDch%20drog%20v%20%C4%8Cesk%C3%A9%20republice.pdf.
- Hrnčiarová J. Závislost u dospělých s poruchou pozornosti s hyperaktivitou (ADHD). Psychiatr praxi. 2021;22(1):17-24.
Go to original source...
- Bakouni H, Sharafi H, Bahremand A, et al. Bupropion for treatment of amphetamine-type stimulant use disorder: A systematic review and meta-analysis of placebo-controlled randomized clinical trials. Drug Alcohol Depend. 2023;253:111018.
Go to original source...
- Mohr P, et al. Klinická psychofarmakologie. Praha: Maxdorf; 2017:441-443.
- Prášil V, Prášilová M. Pregabalin jako zneužívaná substance: kazuistiky léčby závislosti. Psychiatr praxi. 2023;24(2):109-111.
Go to original source...
- Ishikawa H, Takeshima M, Ishikawa H, et al. Pregabalin withdrawal in patients without psychiatric disorders taking a regular dose of pregabalin: A case series and literature review. Neuropsychopharmacol Rep. 2021 Sep;41(3):434-439.
Go to original source...
- Bonnet U, Scherbaum N. Über das Abhängigkeitspotential von gabapentinoids [On the risk of dependence on gabapentinoids]. Fortschr Neurol Psychiatr. 2018 Feb;86(2):82-105.
Go to original source...
- Menšíková K, Nestrašil I, Praško JP. Behaviorální komplikace dopaminergní terapie v pokročilé fázi Parkinsonovy nemoci. Neurol praxi. 2013;14(2):92-95.
- Espi Martinez F, Espi Forcen F, Shapov A, et al. Biperiden dependence: case report and literature review. Case Rep Psychiatry. 2012;2012:949256.
Go to original source...
- Wilson E, Lader M. A review of the management of antidepressant discontinuation symptoms. Ther Adv Psychopharmacol. 2015 Dec;5(6):357-368.
Go to original source...
- Alamo C, García-Garcia P, Lopez Muñoz F, et al. Tianeptine, an atypical pharmacological approach to depression. Rev Psiquiatr Salud Ment (Engl Ed). 2019 Jul Sep;12(3):170-186.
Go to original source...
- Hýža M, Čechová M. Abúsus tianeptinu. Psychiatr praxi. 2014;15(2):75-76.
- SPC léčivého přípravku Coaxil. [Internet]. [cited 2025 05 20]. Available from: www.sukl.cz.
- Kim S, Lee G, Kim E, Jung H, et al. Quetiapine Misuse and Abuse: Is it an Atypical Paradigm of Drug Seeking Behavior? J Res Pharm Pract. 2017 Jan Mar;6(1):12-15.
Go to original source...
- Šatná Z. Lokální dekongestiva v terapii rýmy. Farmacie pro praxi. 2014;5(6):250-252. [Internet]. Available from: https://farmaciepropraxi.cz/pdfs/lek/2014/06/06.pdf.
- Němečková P. Poruchy příjmu potravy. Psychiatrie pro praxi. 2002;3(4):194-197.
- Lembo A. Constipation in adults: Beyond the basics. UpToDate [Internet]. UpToDate; 2024 [cited 2025 05 20]. Available from: www.uptodate.com.
Go to original source...
- Uhlíková P, Trefný M, Kališová L, et al. Úmyslné intoxikace dextrometorfanem. Ces Slov Psychiatr. 2017;113(6):278-282.