Related Experiment Video
Updated: Apr 20, 2026
07:35
Behavioral Characterization of Pentylenetetrazole-induced Seizures: Moving Beyond the Racine Scale
Published on: July 8, 2025
1.9K
Ziconotide-induced psychosis: a case report
Stephanie V Phan1, Julie M Waldfogel2
1University of Georgia College of Pharmacy, Southwest Georgia Clinical Campus, 1000 Jefferson Street, Albany, GA 31701, USA.
General Hospital Psychiatry
|December 3, 2014
Summary
Ziconotide infusion for chronic pain can cause hallucinations and paranoia. Promptly removing the drug and using antipsychotics like risperidone can resolve these severe neuropsychiatric adverse events.
Area of Science:
- Neuroscience
- Psychiatry
- Pharmacology
Background:
- Ziconotide is an intrathecal analgesic for severe chronic pain.
- Neuropsychiatric adverse events are a known risk, but management is often unclear.
- This case highlights a specific presentation of ziconotide-induced psychosis.
Observation:
- A 49-year-old female developed auditory hallucinations and paranoia 3 months after ziconotide pump implantation.
- Symptoms persisted for 3 weeks despite the drug being administered at 4.9 mcg/24 hours.
- The patient was admitted to an acute psychiatric unit for management.
Findings:
- Risperidone was initiated, and the ziconotide pump was subsequently drained, rinsed, and refilled with saline.
- Psychotic symptoms resolved within hours after ziconotide removal.
- The patient was discharged with continued risperidone, experiencing symptom resolution.
Implications:
- This case demonstrates a successful management strategy for ziconotide-induced hallucinations and paranoia.
- Early recognition and intervention, including drug removal and antipsychotic use, are crucial.
- Clinicians need awareness of potential timelines for symptom resolution and the role of supportive care.
