Gabapentin-Induced Overflow Urinary Incontinence: A Case Report and Review of the Literature

Area of Science:

• Palliative Care
• Neurology
• Oncology

Background:

• Gabapentin (GBP), a gamma-aminobutyric acid (GABA) analog, is frequently used in palliative care for managing neuropathic pain, anxiety, and other symptoms.
• Urinary incontinence (UI) is an uncommon but reported adverse effect of GBP.
• This case highlights a potential link between GBP and overflow UI in a patient with metastatic non-small cell lung cancer.

Approach:

• A 61-year-old male patient with metastatic non-small cell lung cancer developed probable overflow UI while on GBP for chemotherapy-induced peripheral neuropathy.
• The patient self-tapered GBP, which resolved the UI but inadequately controlled his bilateral foot pain.
• Palliative care management involved rotating to pregabalin, which successfully managed pain without recurrence of UI.

Key Points:

• The patient experienced resolution of overflow UI upon reducing GBP dosage.
• Substituting with pregabalin achieved effective pain control at comparable doses without UI.
• This case suggests pregabalin as a viable alternative for pain management when GBP causes UI.

Conclusions:

• Healthcare professionals should consider Gabapentin (GBP) as a potential cause for new-onset overflow urinary incontinence.
• Pregabalin may serve as an effective alternative for pain management in patients experiencing UI with GBP.
• This report is the first to describe successful pain control with pregabalin after GBP-induced UI.