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Hydromorphone-Induced Tactile Hallucinations: Rare Opioid Side Effect.

Miki Kiyokawa1,2, William F Haning1

  • 1Psychiatry, University of Hawaii John A. Burns School of Medicine, Honolulu, USA.

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Summary

Opioid medications can cause hallucinations, including rare tactile experiences. This case highlights hydromorphone-induced visual and tactile hallucinations, emphasizing physician awareness of opioid side effects.

Keywords:
formicationhydromorphoneopioid side effectstactile hallucination

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Area of Science:

  • Pharmacology
  • Neurology
  • Toxicology

Background:

  • Opioids are potent analgesics frequently prescribed for pain management.
  • In 2018, approximately 168 million opioid prescriptions were issued in the U.S.
  • Adverse events affect up to 80% of patients on opioid therapy.

Observation:

  • Hallucinosis, though uncommon, is a known opioid side effect.
  • Opioid-induced hallucinations are typically auditory and visual, rarely tactile.
  • These symptoms may be misdiagnosed as underlying psychiatric conditions.

Findings:

  • This report details a case of oral hydromorphone inducing both visual and tactile hallucinations.
  • Discontinuation of hydromorphone resulted in the immediate resolution of psychotic symptoms.
  • This is the first documented instance of hydromorphone causing tactile hallucinations.

Implications:

  • Physicians should remain vigilant for opioid-induced hallucinosis, even as prescriptions decline.
  • Accurate identification of opioid side effects is crucial for appropriate patient management.
  • Increased awareness of this adverse effect can prevent misdiagnosis and guide treatment decisions.