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Rabeprazole and psychiatric symptoms.
Giovanni Polimeni1, Paola Cutroneo, Adele Gallo
1Istituto di Ricovero e Cura a Carattere Scientifico Centro Neurolesi Bonino-Pulejo, Messina, Italy. gpolimeni@unime.it
The Annals of Pharmacotherapy
|July 5, 2007
Summary
Rabeprazole, a proton pump inhibitor (PPI), may cause anxiety and panic attacks. Discontinuing rabeprazole led to symptom resolution, suggesting a link between this PPI and neuropsychiatric effects.
Area of Science:
- Neurogastroenterology
- Psychiatry
- Pharmacology
Background:
- Proton pump inhibitors (PPIs) are widely used for acid-related gastrointestinal disorders.
- Neuropsychiatric adverse effects of PPIs are increasingly recognized but not fully understood.
Observation:
- A 55-year-old woman developed severe anxiety, panic attacks, and confusion 10 days after initiating rabeprazole.
- These neuropsychiatric symptoms resolved within 2 days of discontinuing rabeprazole.
Findings:
- Rabeprazole was identified as the probable cause of the adverse reaction based on the Naranjo scale.
- The patient experienced no psychiatric symptoms upon switching to esomeprazole.
- Rabeprazole-induced hypergastrinemia is hypothesized to mediate the neuropsychiatric effects via gastrin-releasing peptide.
Implications:
- This case highlights a potential link between rabeprazole and neuropsychiatric adverse events.
- Further research is warranted to explore the role of PPI-induced hypergastrinemia in neuropsychiatric disorders.
- Clinicians should consider PPIs as a potential cause of unexplained anxiety or panic attacks.
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