Abuse of pregabalin and gabapentin for their euphoric effects may only be part of the story.1 Pregabalin has also been associated with suicidal ideation234 and depressed mood.45 In a small case series, approximately 10% of patients recently started on pregabalin treatment experienced changes in mood and developed depression or suicidal ideation, or both, which improved on cessation or dose reduction.4 Monitoring for depression after starting treatment and increasing dose may also help to reduce the death toll.