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Neurological excitation in a 6-week-old male infant after morphine overdose

Jörg Thomas1, Nils I Corson2, Anke Meinhold3

  • 1Department of Anesthesia, University Children´s Hospital, Zurich, Switzerland.

Paediatric Anaesthesia
|August 22, 2019
PubMed

Insights

Morphine overdose can cause neuro-excitation in infants, likely due to elevated levels of the metabolite morphine-3-glucuronide. This contrasts with the more commonly known respiratory depression side effect.

Area of Science:

  • Pharmacology
  • Neuroscience
  • Toxicology

Background:

  • Opioid overdose, particularly morphine, is a significant clinical concern.
  • Respiratory depression is a well-documented adverse effect of morphine overdose.
  • The neuro-excitatory effects of morphine metabolites are less understood.

Observation:

  • A case report details an infant experiencing neurological excitation following a morphine overdose.
  • The infant presented with symptoms of central nervous system hyperexcitability.
  • This presentation was unusual given the typical side effect profile of morphine.

Findings:

  • The infant's neuro-excitation was likely attributed to elevated concentrations of morphine-3-glucuronide.
  • Morphine-3-glucuronide, a metabolite of morphine, may possess neuro-excitatory properties.
  • This highlights a less recognized, potentially dangerous side effect of morphine overdose.

Implications:

  • Clinicians should consider neuro-excitation as a potential side effect in cases of pediatric morphine overdose.
  • Monitoring for and understanding the role of morphine metabolites like morphine-3-glucuronide is crucial.
  • Further research is warranted to elucidate the mechanisms and clinical significance of morphine metabolite-induced neuro-excitation.
Keywords:
metabolitesmorphinemorphine-3-glucuronideneuro-excitationoverdosepain therapy

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