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Gabapentin-related suicide: Myth or fact?
Ramsis F Ghaly1,2,3, Ana Plesca1, Shalini Rana1
1Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, Illinois, USA.
Surgical Neurology International
|November 30, 2018
Summary
Gabapentin, an alternative to opioids for pain, may cause severe mood changes and suicidal thoughts. Discontinuing the drug resolved these adverse effects in a patient with spinal degenerative disease.
Area of Science:
- Neurology
- Psychiatry
- Pain Management
Background:
- The opioid epidemic is a leading cause of death in adults under 50.
- Gabapentin is considered a primary alternative analgesic medication to reduce opioid prescriptions.
Observation:
- A patient undergoing multimodal treatment for painful spinal degenerative disease was prescribed gabapentin.
- Following gabapentin initiation, the patient reported personality changes, including increased depression, frustration, and aggression.
- These mood changes, coupled with uncontrolled pain, led to a suicide attempt.
Findings:
- Discontinuation of gabapentin resulted in the complete resolution of the patient's suicidal ideation.
- Gabapentin use was associated with significant adverse psychiatric effects, including depression, aggression, and suicidal ideation.
Implications:
- Healthcare providers must screen for psychiatric disorders before prescribing gabapentin for pain management.
- Increased awareness of gabapentin's potential psychiatric side effects is crucial for patient safety.
- Careful monitoring is essential for patients on gabapentin, especially those with pre-existing mental health conditions.
