Delirium, psychosis, and visual hallucinations induced by pregabalin

Pedroso, José Luiz; Nakama, Gilberto Yoshinobu; Filho, Mário Carneiro; Barsottini, Orlando Graziani Póvoas

doi:10.1590/s0004-282x2012001200012

Cited by 16 publications

(7 citation statements)

References 5 publications

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“…Psychotic symptoms and episodes as an expression of an iatrogenic phenomenon have been reported with most AEDs, including the first generation AEDs ethosuximide, phenytoin, phenobarbital, and primidone, 48,49 as well as the newer AEDs, such as vigabatrin, topiramate, levetiratecetam, zonisamide, lacosamide, pregabalin, and parampanel. [50][51][52][53][54] The clinical differentiation between APE and a toxic reaction can be difficult if a seizure-free state followed the introduction of the AED.…”

Section: Iatrogenic Psychotic Episodes Aed-related Psychotic Episodesmentioning

confidence: 99%

Psychosis of epilepsy: a multifaceted neuropsychiatric disorder

Kanner

Rivas-Grajales

2016

CNS Spectr.

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Psychosis of epilepsy (POE) is a term applied to a group of psychotic disorders with a distinct phenomenology in which potential etiopathogenic mechanisms are believed to be closely related to a seizure disorder. POE can present as interictal psychotic episodes, which may often differ semiologically from primary schizophrenic disorder. They may present as ictal or postictal psychotic episodes and may be the expression of an iatrogenic process to pharmacologic and/or surgical interventions.Epilepsy and POE have a complex and bidirectional relation, as not only are patients with epilepsy at greater risk of developing a psychotic disorder, but patients with a primary psychotic disorder are also at greater risk of developing epilepsy. The prevalence of POE is more than 7 times higher than the frequency of primary schizophreniform disorders in the general population. While POE has been associated with focal epilepsy of temporal and frontal lobe origin, its etiology and pathophysiology of POE have yet to be established.The treatment of all forms of POE, with the exception of ictal psychotic episodes, requires the use of antipsychotic drugs, preferably the atypical antipsychotic agents with a very low or negligible potential to lower the seizure threshold (eg, risperidone, apiprazole), starting at a low dose with stepwise increments.

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Section: Iatrogenic Psychotic Episodes Aed-related Psychotic Episodesmentioning

confidence: 99%

Psychosis of epilepsy: a multifaceted neuropsychiatric disorder

Kanner

Rivas-Grajales

2016

CNS Spectr.

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“…Psychotic symptoms have been reported in case reports as consequences of pregabalin use 5,6,7 and cessation, 8 as well as following the initiation 9 and cessation 10,11 of the closely related medication gabapentin. Several substances that increase GABA receptor activity are well known to cause psychotic symptoms on discontinuation, including alcohol and benzodiazepines.…”

Section: Discussionmentioning

confidence: 99%

Depression with psychosis following pregabalin discontinuation

Sadik

Jelley

Ward

2021

Prog Neurol Psychiatry

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“…A systematic review of randomized controlled trials, documented the most common side effects of pregabalin including dizziness, vertigo, incoordination, balance disorder, ataxia, diplopia, blurred vision, tremor, drowsiness, confusion, disturbance of attention, euphoria, disorganized thinking and fatigue [8]. Adverse reactions occur more often at high doses and pregabalin has been associated with psychosis, hallucinations and other neuropsychiatric symptoms when titrated rapidly [9,10]. In contrast to these studies which suggest that visual hallucinations from pregabalin are mainly attributed to rapid titration, our study indicates that this side effect may be dose depended and can appear in cases of slow titration as well, as happened in our case.…”

Section: Discussionmentioning

confidence: 99%

Pregabalin induced visual hallucinations – a rare adverse reaction

Mousailidis

Papanna

Salmon

et al. 2020

BMC Pharmacol Toxicol

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Background: Pregabalin is an anticonvulsive, analgesic and anxiolytic medication. The typical side effects include dizziness, somnolence and weight gain. Few studies or case reports have demonstrated psychiatric side effects resulting from its use. Case presentation: We present a patient who suffered visual hallucinations and agitation associated with an increase in pregabalin dose, resolving completely after pregabalin discontinuation.Conclusions: Acute visual hallucinations should be considered in the clinical spectrum of very rare side effects of pregabalin use, especially at higher doses. Tapered discontinuation of the medication can improve and resolve symptoms.

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Delirium, psychosis, and visual hallucinations induced by pregabalin

Cited by 16 publications

References 5 publications

Psychosis of epilepsy: a multifaceted neuropsychiatric disorder

Psychosis of epilepsy: a multifaceted neuropsychiatric disorder

Depression with psychosis following pregabalin discontinuation

Pregabalin induced visual hallucinations – a rare adverse reaction

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