Hypersalivation and coarse tremors as uncommon side effects of acamprosate: A case report

Introduction Mr. X, a 39-year-old man presented to us with a history of alcohol use from the last 12-15 years in a dependence pattern with tolerance, uncomplicated withdrawal symptoms and salience. He was detoxified, given parenteral thiamine supplements and oral lorazepam to reduce withdrawal sym...

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Main Authors: D. Bhandutia, S. Nayok
Format: Article
Language:English
Published: Cambridge University Press 2021-04-01
Series:European Psychiatry
Subjects:
Online Access:https://www.cambridge.org/core/product/identifier/S0924933821020599/type/journal_article
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author D. Bhandutia
S. Nayok
author_facet D. Bhandutia
S. Nayok
author_sort D. Bhandutia
collection DOAJ
description Introduction Mr. X, a 39-year-old man presented to us with a history of alcohol use from the last 12-15 years in a dependence pattern with tolerance, uncomplicated withdrawal symptoms and salience. He was detoxified, given parenteral thiamine supplements and oral lorazepam to reduce withdrawal symptoms. He was contemplating to quit alcohol and thus about 4-5 days after his detoxification, tablet acamprosate 1998 mg/day was added, in three divided dosages. He was discharged after 10 days and had no withdrawal signs or cerebellar deficits. In the next follow-up after two weeks, he reported to be abstinent from alcohol, but now complained of new onset coarse tremors and excessive salivation. He had no other extra pyramidal or cerebellar symptoms, no hepatic or renal dysfunction and no neurological deficits. The Patient had a drooling score of 6 on Drooling Severity and Frequency Scale(DSFS). Objectives Acamprosate and naltrexone are the only two drugs approved by the US Food and Drug Administration for achieving abstinence in patients with Alcohol Dependence Syndrome. Acamprosate is well tolerated and has a few drug interactions. It has a comparatively benign side effect profile which includes diarrhea, intestinal cramps, itching, dizziness, muscle weakness, headache, flatulence, nausea, anxiety, and insomnia. Here we report hypersalivation and coarse tremors as unusual side effects of acamprosate. Methods Cross-sectional Results Here we report hypersalivation and coarse tremors as unusual side effects of acamprosate. Conclusions The probable mechanism responsible for this is thought to be acamprosate induced decrease in dopamine release in ventral tegmental area due to diminished glutamate activity. Disclosure No significant relationships.
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spelling doaj.art-4707e4afe704434fa669160de2e098bb2023-11-17T05:05:29ZengCambridge University PressEuropean Psychiatry0924-93381778-35852021-04-0164S778S77810.1192/j.eurpsy.2021.2059Hypersalivation and coarse tremors as uncommon side effects of acamprosate: A case reportD. Bhandutia0S. Nayok1Psychiatry, Sri Siddhartha Medical College, Tumakuru, IndiaPsychiatry, Sri Siddhartha Medical College, Tumakuru, India Introduction Mr. X, a 39-year-old man presented to us with a history of alcohol use from the last 12-15 years in a dependence pattern with tolerance, uncomplicated withdrawal symptoms and salience. He was detoxified, given parenteral thiamine supplements and oral lorazepam to reduce withdrawal symptoms. He was contemplating to quit alcohol and thus about 4-5 days after his detoxification, tablet acamprosate 1998 mg/day was added, in three divided dosages. He was discharged after 10 days and had no withdrawal signs or cerebellar deficits. In the next follow-up after two weeks, he reported to be abstinent from alcohol, but now complained of new onset coarse tremors and excessive salivation. He had no other extra pyramidal or cerebellar symptoms, no hepatic or renal dysfunction and no neurological deficits. The Patient had a drooling score of 6 on Drooling Severity and Frequency Scale(DSFS). Objectives Acamprosate and naltrexone are the only two drugs approved by the US Food and Drug Administration for achieving abstinence in patients with Alcohol Dependence Syndrome. Acamprosate is well tolerated and has a few drug interactions. It has a comparatively benign side effect profile which includes diarrhea, intestinal cramps, itching, dizziness, muscle weakness, headache, flatulence, nausea, anxiety, and insomnia. Here we report hypersalivation and coarse tremors as unusual side effects of acamprosate. Methods Cross-sectional Results Here we report hypersalivation and coarse tremors as unusual side effects of acamprosate. Conclusions The probable mechanism responsible for this is thought to be acamprosate induced decrease in dopamine release in ventral tegmental area due to diminished glutamate activity. Disclosure No significant relationships. https://www.cambridge.org/core/product/identifier/S0924933821020599/type/journal_articleAcamprosateHypersalivation
spellingShingle D. Bhandutia
S. Nayok
Hypersalivation and coarse tremors as uncommon side effects of acamprosate: A case report
European Psychiatry
Acamprosate
Hypersalivation
title Hypersalivation and coarse tremors as uncommon side effects of acamprosate: A case report
title_full Hypersalivation and coarse tremors as uncommon side effects of acamprosate: A case report
title_fullStr Hypersalivation and coarse tremors as uncommon side effects of acamprosate: A case report
title_full_unstemmed Hypersalivation and coarse tremors as uncommon side effects of acamprosate: A case report
title_short Hypersalivation and coarse tremors as uncommon side effects of acamprosate: A case report
title_sort hypersalivation and coarse tremors as uncommon side effects of acamprosate a case report
topic Acamprosate
Hypersalivation
url https://www.cambridge.org/core/product/identifier/S0924933821020599/type/journal_article
work_keys_str_mv AT dbhandutia hypersalivationandcoarsetremorsasuncommonsideeffectsofacamprosateacasereport
AT snayok hypersalivationandcoarsetremorsasuncommonsideeffectsofacamprosateacasereport