Disturbance of consciousness and involuntary movements caused by pregabalin

Shimizu, Taro; Yoshida, Tsuneyasu; Kitamura, Koichi; Hamada, Osamu

doi:10.1136/bcr-2012-007559

Cited by 5 publications

(2 citation statements)

References 20 publications

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“…For the years 1999 and 2019, a total of 46 reports containing 305 cases who developed MDs after the use of PGB from 17 different countries were reported [ Table 1 ]. [ 2 3 10 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 ] The origin was North American in 196, European in 68, Asian in 40, and South American in 1. The MDs associated with PGB found were as follows: 184 patients with ataxia, 61 with tremors, 39 with MCL, 8 with parkinsonism, 1 with restless legs syndrome, 1 with dystonia, 1 with dyskinesia, and 1 with akathisia.…”

Section: Resultsmentioning

confidence: 99%

Pregabalin-associated movement disorders: A literature review

Rissardo

Caprara

2020

Brain Circ

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Central nervous system adverse effects are commonly reported with pregabalin (PGB). On the other hand, movement disorders (MDs) associated with this drug were rarely described. However, their occurrence could significantly affect the quality of life of PGB users. This literature review aims to evaluate the clinical epidemiological profile, pathological mechanisms, and management of PGB-associated MDs. Relevant reports in six databases were identified and assessed by two reviewers without language restriction. A total of 46 reports containing 305 cases from 17 countries were assessed. The MDs encountered were as follows: 184 individuals with ataxia, 61 with tremors, 39 with myoclonus, 8 with parkinsonism, 1 with restless legs syndrome, 1 with dystonia, 1 with dyskinesia, and 1 with akathisia. The mean age was 62 years (range: 23–94). The male sex was slightly predominant with 54.34%. The mean PGB dose when the MD occurred was 238 mg, and neuropathic pain was the most common indication of PGB. The time from PGB start to MD was < 1 month at 75%. The time from PGB withdrawal to recovery was < 1 week at 77%. All the individuals where the follow-up was reported had a full recovery. The most common management was PGB withdrawal. In the literature, the majority of the cases did not report information about timeline events, neurological examination details, or electrodiagnostic studies. The best management for all MDs is probably PGB withdrawal. If the patient is on dialysis program, perhaps an increased number of sessions will decrease recovery time. Furthermore, the addition of a benzodiazepine could accelerate recovery.

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Section: Resultsmentioning

confidence: 99%

Pregabalin-associated movement disorders: A literature review

Rissardo

Caprara

2020

Brain Circ

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“…In some cases it was shown that add-on therapy of pregabalin can induce myoclonus in patients with seizure history. In patients with renal failure pregabalin also can evoke myoclonic seizures [11][12][13].…”

Section: Discussionmentioning

confidence: 99%

Nasal pregabalin overdose and myclonus: a new way of misuse

Öztürk

Morkavuk

2018

Psychiatry and Clinical Psychopharmacology

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Pregabalin reduces central neuronal excitability and has gamma-aminobutyric acid-mimetic features, which was demonstrated in rats. Pregabalin is indicated for the treatment of neuropathic pain, post-herpetic neuralgia, fibromyalgia and partial seizures. However, pregabalin is widely used for off-label conditions. Euphoria is a frequent side effect of pregabalin and several cases of overdose from recreational use have been reported until recently. Our aim is to present a case of a patient with myoclonus after high dose nasal pregabalin misuse. A 23-year-old female patient presented to the emergency department with unconsciousness and involuntary movements in her arms. She used, 10-15 numbers of 300 mg pregabalin capsules by nasal inhalation for recreational purpose for the first time. Her vital signs were within normal limits. The patient's serum ethanol, drug and substance levels were negative. During the examination, myoclonus with 2-3 beats was occasionally observed in the upper extremities. Emergency brain computed tomography was normal. During the electroencephalography (EEG monitorization, one generalized spikewave activity was observed for a second. We started 800 mg valproic acid i.v. therapy and prescribed valproic acid 500 mg/day p.o. at discharge. One week after discharge, she had no myoclonic jerks even though she did not use the recommended antiepileptic drug. Control EEG was within normal limits. Pregabalin overdose was suggested to be relatively safe but myoclonic seizures should be taken into consideration as a side effect. ARTICLE HISTORY

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Antiepileptic Drugs

Beal¹

2014

Side Effects of Drugs Annual

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Disturbance of consciousness and involuntary movements caused by pregabalin

Cited by 5 publications

References 20 publications

Pregabalin-associated movement disorders: A literature review

Pregabalin-associated movement disorders: A literature review

Nasal pregabalin overdose and myclonus: a new way of misuse

Antiepileptic Drugs

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