Related Experiment Videos
Alendronate-induced auditory hallucinations and visual disturbances
Craig I Coleman1, Kristen A Perkerson, Anne Lewis
1School of Pharmacy, University of Connecticut, Storrs, Connecticut, USA.
Pharmacotherapy
|June 30, 2004
Summary
Switching bisphosphonate therapy for osteoporosis from daily to weekly alendronate likely caused auditory and visual hallucinations in a patient. This rare central nervous system side effect warrants clinical awareness.
Area of Science:
- Pharmacology
- Neuroscience
- Clinical Medicine
Background:
- Osteoporosis management often involves bisphosphonates like alendronate.
- Alendronate is available in daily and weekly dosing regimens.
- Adverse drug events require thorough causality assessment.
Observation:
- A 79-year-old woman experienced auditory hallucinations and visual disturbances after switching from daily to weekly alendronate.
- The onset of symptoms occurred shortly after the change in alendronate dosing frequency.
- Naranjo and Jones causality algorithms indicated a probable to highly probable link between the switch and the adverse events.
Findings:
- The patient's central nervous system (CNS) symptoms, including hallucinations, were temporally associated with the altered bisphosphonate regimen.
- Previous reports suggest other bisphosphonates can induce auditory, visual, and olfactory hallucinations.
- The underlying mechanism for bisphosphonate-induced CNS toxicity is not fully understood but appears independent of calcium regulation.
Implications:
- Clinicians should consider rare CNS toxicity, such as hallucinations, as a potential adverse effect of bisphosphonate therapy.
- The switch from daily to weekly dosing of bisphosphonates may be a critical factor in the manifestation of these rare side effects.
- Enhanced vigilance for neurological symptoms is recommended in patients undergoing bisphosphonate treatment for osteoporosis.