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Related Experiment Videos

Gabapentin withdrawal presenting as status epilepticus.

Fermin Barrueto1, Jonah Green, Mary Ann Howland

  • 1Department of Emergency Medicine, New York University School of Medicine and the New York City Poison Control Center, New York, New York 10016, USA. fbarrueto@hotmail.com

Journal of Toxicology. Clinical Toxicology
|January 1, 2003
PubMed
Summary

High-dose gabapentin (8000 mg/day) can lead to severe withdrawal symptoms. Abrupt cessation in a patient with chronic back pain precipitated status epilepticus, a rare but serious complication.

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Area of Science:

  • Neurology
  • Pharmacology

Background:

  • Gabapentin is commonly prescribed for neuropathic pain.
  • Therapeutic doses typically range up to 4800 mg/day.
  • This case involves a patient on a significantly higher dose for chronic back pain.

Observation:

  • A 34-year-old male patient was on 8000 mg/day of gabapentin for lumbar disc disease.
  • The patient experienced a 2-day interruption in his medication supply.
  • He presented to the emergency department with generalized seizures and status epilepticus.

Findings:

  • No prior history of seizure disorder was noted.
  • Medical evaluation ruled out other causes for the seizures.
  • This is the first reported case of generalized seizures and status epilepticus attributed to gabapentin withdrawal.

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Implications:

  • Clinicians should be aware of the potential for severe neurological events during gabapentin withdrawal.
  • Abrupt discontinuation of high-dose gabapentin may require careful management.
  • Further research into the neurophysiological mechanisms of gabapentin withdrawal is warranted.