Gabapentin-induced coma in a patient with renal failure

Area of Science:

• Pharmacology
• Nephrology
• Neurology

Background:

• Gabapentin is a commonly prescribed anticonvulsant and analgesic.
• Sciatalgia, or sciatic pain, is a common condition often treated with gabapentin.
• Renal function plays a crucial role in drug metabolism and excretion.

Observation:

• A 60-year-old woman presented with coma after receiving a single dose of gabapentin for right-sided sciatalgia.
• The patient's neurological status significantly improved following hemodialysis treatment.

Findings:

• This case suggests a potential link between gabapentin administration and acute neurological toxicity, even in patients without pre-existing renal failure.
• Hemodialysis effectively removed gabapentin from the bloodstream, leading to clinical improvement.

Implications:

• Clinicians should consider gabapentin toxicity in patients presenting with altered mental status, particularly those with impaired renal function.
• Careful dosing and monitoring of gabapentin are essential, especially in vulnerable patient populations.
• This case underscores the importance of considering drug-induced toxicity in differential diagnoses for neurological changes.