Nasal pregabalin overdose and myclonus: a new way of misuse

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-lab...

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Main Authors: H. Mihrimah Ozturk, Gülin Morkavuk
Format: Article
Language:English
Published: AVES 2019-04-01
Series:Psychiatry and Clinical Psychopharmacology
Subjects:
Online Access:http://dx.doi.org/10.1080/24750573.2017.1422959
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author H. Mihrimah Ozturk
Gülin Morkavuk
author_facet H. Mihrimah Ozturk
Gülin Morkavuk
author_sort H. Mihrimah Ozturk
collection DOAJ
description 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.
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spelling doaj.art-e13bd4e724164fe7b392da96a91f2dc32023-02-15T16:15:43ZengAVESPsychiatry and Clinical Psychopharmacology2475-05812019-04-0129221621910.1080/24750573.2017.14229591422959Nasal pregabalin overdose and myclonus: a new way of misuseH. Mihrimah Ozturk0Gülin Morkavuk1Ufuk University Faculty of MedicineUfuk University Faculty of MedicinePregabalin 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.http://dx.doi.org/10.1080/24750573.2017.1422959pregabalin misusemyoclonusseizureabuseoverdose
spellingShingle H. Mihrimah Ozturk
Gülin Morkavuk
Nasal pregabalin overdose and myclonus: a new way of misuse
Psychiatry and Clinical Psychopharmacology
pregabalin misuse
myoclonus
seizure
abuse
overdose
title Nasal pregabalin overdose and myclonus: a new way of misuse
title_full Nasal pregabalin overdose and myclonus: a new way of misuse
title_fullStr Nasal pregabalin overdose and myclonus: a new way of misuse
title_full_unstemmed Nasal pregabalin overdose and myclonus: a new way of misuse
title_short Nasal pregabalin overdose and myclonus: a new way of misuse
title_sort nasal pregabalin overdose and myclonus a new way of misuse
topic pregabalin misuse
myoclonus
seizure
abuse
overdose
url http://dx.doi.org/10.1080/24750573.2017.1422959
work_keys_str_mv AT hmihrimahozturk nasalpregabalinoverdoseandmyclonusanewwayofmisuse
AT gulinmorkavuk nasalpregabalinoverdoseandmyclonusanewwayofmisuse