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Akathisia induced by gabapentin withdrawal.
Sharon See1, Erin Hendriks, Leslie Hsiung
1St. John's University College of Pharmacy and Allied Health Professions, Jamaica, NY, USA. sees@stjohns.edu
The Annals of Pharmacotherapy
|June 10, 2011
Summary
Abruptly stopping gabapentin can cause akathisia, a movement disorder characterized by inner restlessness. This case highlights the importance of gradually tapering gabapentin to prevent withdrawal symptoms in patients with type 2 diabetes.
Area of Science:
- Neurology
- Pharmacology
Background:
- Gabapentin is commonly prescribed for neuropathic pain, including diabetic neuropathy.
- Abrupt medication cessation can lead to withdrawal syndromes, though specific data on gabapentin is limited.
Observation:
- A 76-year-old female with type 2 diabetes developed akathisia after suddenly stopping gabapentin (3600 mg daily).
- Symptoms included agitation and uncontrollable limb movements, consistent with akathisia.
- Restarting gabapentin led to rapid symptom resolution.
Findings:
- This is the first reported case of akathisia specifically linked to gabapentin withdrawal.
- The Naranjo scale indicated a probable association between the akathisia and gabapentin discontinuation.
- Withdrawal symptoms can occur even after short-term use (as little as 1 month).
Implications:
- Gradual tapering of gabapentin is recommended to avoid potential withdrawal symptoms like akathisia.
- Physicians should consider gabapentin withdrawal as a potential cause of akathisia in patients discontinuing the medication.
- Prompt re-initiation of gabapentin can effectively manage withdrawal-induced akathisia.
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