Negative myoclonus associated with pregabalin

Park, Kwan-Do; Kim, Min-Ku; Lee, Se Jin

doi:10.12701/yujm.2018.35.2.240

Cited by 5 publications

(5 citation statements)

References 12 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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“…PGB is believed to modulate the activation and release of many excitatory neurotransmitters, leading to a reduction in levels of anxiety 9 . Preclinical data has shown that PGB possess anxiolytic properties.…”

Section: Discussionmentioning

confidence: 99%

“…PGB reduces depolarization-induced Ca ++ entry via presynaptic Ca ++ channels in the central nervous system (CNS) 8 . The release of numerous excitatory neurotransmitters is reduced including glutamate, calcitonin gene related peptide (CGRP), norepinephrine (NE) and substance p, thus producing inhibitory modulation of overexcited neurons and returning them to a normal level 9 . It not produce any effect after binding to GABAA, GABAB or BZD receptors.…”

Section: Introductionmentioning

confidence: 99%

The Effect of High Dose and Low Dose Pregabalin as Premedication on Preoperative Anxiety and Sedation Levels

Zafar

2021

PAFMJ

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Objective: To assess the role of pregabalin as premedication for preoperative sedation & anxiolysis with two different doses in laparoscopic cholecystectomy patients. Study Design: Prospective, randomized control study Place and Duration of Study: Department of Pharmacology and Therapeutics, Army Medical College, Rawalpindi in collaboration with Department of Anesthesiology, CMH, Rawalpindi from February 2019 to July 2019. Patients & Methods: 96 patients of either gender, aged between 18 to 60 years with ASA grade I-II, undergoing elective laparoscopic cholecystectomy were enrolled in this study. They were randomly divided into three groups having 32 patients each. Group 1 received oral placebo drug, Group 2 received oral pregabalin 150 mg, whereas Group 3 received oral pregabalin 300mg with sip of water 90 mins before the induction of general anesthesia. The effects of drugs on the patient’s level of sedation and anxiety were evaluated at baseline and before the induction of anesthesia using Ramsay Sedation Score and Beck Anxiety Inventory respectively. Results: Premedication with pregabalin 150mg and 300mg significantly produced sedation as compared to placebo. Though, pregabalin 300mg exhibited more sedation than pregabalin 150mg but the difference between them was statistically insignificant (p >0.05). Preoperative administration of pregabalin was related with anxiolysis, with the most prominent results shown by pregabalin 300mg (p <0.05) whereas pregabalin 150mg couldn’t alleviate anxiety and the results were statistically insignificant (p >0.05). Conclusions: Premedication with pregabalin 300mg, 90 mins before the induction of general anesthesia is an effective regimen to alleviate preoperative anxiety and sedation.

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“…There have been several case reports and case series of drug-induced NM, including gabapentin and pregabalin [ 4 , 14 ]. Drug-induced NM is usually believed to be of subcortical origin because of the absence of cortical correlates of NM in the electrophysiological tests [ 2 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

Negative myoclonus associated with tramadol use

Bae

Lee

2020

Yeungnam Univ J Med

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Negative myoclonus (NM) is a brief involuntary jerky movement caused by a sudden lapse of tonic muscle contraction in the affected body segments. NM may appear not only in normal individuals physiologically during fear or sleep transition but also in patients with metabolic encephalopathy as flapping tremor (asterixis) [1-3]. Anticonvulsants, such as gabapentin and pregabalin, may also induce NM [4]. Tramadol, a synthetic codeine, is an analgesic used to treat various types of pain and is known to provoke generalized tonic-clonic seizure or myoclonus [5-8]. However, based on the Korean literature, studies assessing the presence of NM due to tramadol use have not been conducted yet. We hereby report a case of NM caused by the therapeutic dose of tramadol. Case This study was approved by the Institutional Review Board of the Negative myoclonus (NM) is a shock-like jerky involuntary movement caused by a sudden, brief interruption of tonic muscle contraction. NM is observed in patients diagnosed with epilepsy, metabolic encephalopathy, and drug toxicity and in patients with brain lesions. A 55-year-old man presented with NM in both his arms and neck. He has taken medications containing tramadol at a dose of 80-140 mg/day for 5 days due to common cold. He had no history of seizures. Acute lesions were not observed during magnetic resonance imaging, and abnormal findings in his laboratory tests were not noted. His NM resolved completely after the discontinuation of tramadol and the oral administration of clonazepam. Our case report suggests that tramadol can cause NM in patients without seizure history or metabolic disorders, even within its therapeutic dose.

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Negative myoclonus associated with pregabalin

Cited by 5 publications

References 12 publications

Pregabalin-associated movement disorders: A literature review

Pregabalin-associated movement disorders: A literature review

The Effect of High Dose and Low Dose Pregabalin as Premedication on Preoperative Anxiety and Sedation Levels

Negative myoclonus associated with tramadol use

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