Visual hallucinations associated with gabapentin use.

Area of Science:

• Neuroscience
• Pharmacology
• Clinical Medicine

Background:

• Gabapentin is a widely prescribed anticonvulsant and analgesic medication.
• Neuropathic pain is a common and often challenging condition to manage.
• Visual hallucinations are a rare but reported side effect of gabapentin therapy.

Observation:

• A 65-year-old woman with no prior psychiatric history developed visual hallucinations.
• The hallucinations began approximately one month after initiating gabapentin for post-surgical neuropathic pain.
• The patient was taking a total daily dose of 1800 mg of gabapentin, exceeding the typical prescribed regimen.

Findings:

• Hallucinations occurred 2-3 times per month and resolved after the patient self-reduced her gabapentin dosage.
• Complete cessation of gabapentin led to the complete resolution of visual hallucinations.
• The Naranjo adverse drug reaction scale indicated a probable link between gabapentin and the visual hallucinations.

Implications:

• This case highlights the importance of considering gabapentin as a potential cause of visual hallucinations, even in patients without a psychiatric history.
• Clinicians should carefully monitor patients for adverse effects, particularly visual disturbances, when prescribing gabapentin.
• Dosage adjustments and discontinuation of gabapentin should be considered in patients experiencing such symptoms.