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Mania associated with ranitidine: a case report and review of literature
Audrey Mauran1, Tudi Goze2, Delphine Abadie1
1Department of Medical and Clinical Pharmacology, Pharmacopôle Midi-Pyrénées, Centre Midi-Pyrénées de PharmacoVigilance, de Pharmacoépidémiologie et d'Informations sur le Médicament, CIC INSERM 1436, Faculté de Médecine, Centre Hospitalier Universitaire, University of Toulouse, Toulouse, France.
Abstract:
H2 receptor antagonists can be associated with central adverse drug reactions (ADRs), like confusion, delirium, hallucinations, slurred speech or headaches. We report here a 'serious' case of severe mania leading to hospitalization in a 42-year-old alcohol-dependent man, 4 days after ranitidine introduction. Review of literature showed that this 'very rare' ADR occurs mainly in patients with predisposing factors: age, decrease in renal and/or hepatic function, polymedication, alcohol. Knowledge of this ADR can be particularly important for these drugs widely used as self-medication.
Insights
H2 receptor antagonists like ranitidine can cause central adverse drug reactions. A case study highlights severe mania in an alcohol-dependent patient, emphasizing risks in those with predisposing factors.
Area of Science:
- Pharmacology
- Neuroscience
- Clinical Medicine
Background:
- H2 receptor antagonists are widely used for acid reflux and ulcers.
- Central adverse drug reactions (ADRs) are known but rare side effects.
- These ADRs can manifest as cognitive and neurological disturbances.
Observation:
- A 42-year-old male with alcohol dependence developed severe mania.
- The mania occurred 4 days after initiating ranitidine, an H2 receptor antagonist.
- This event led to hospitalization, indicating a serious adverse drug reaction.
Findings:
- Literature review indicates this ADR is very rare.
- Predisposing factors include advanced age, impaired renal or hepatic function, and concurrent alcohol use.
- The patient's alcohol dependence was a significant contributing factor.
Implications:
- Clinicians should be aware of potential central ADRs with H2 receptor antagonists.
- Vigilance is crucial in patients with risk factors like alcohol dependence.
- This knowledge is important given the widespread self-medication with these agents.
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