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Choreoathetoid movements associated with rapid adjustment to methadone
U Bonnet1, M Banger, J Wolstein
1Department of General Psychiatry, University of Essen, Germany.
Pharmacopsychiatry
|October 1, 1998
Summary
Methadone, a selective mu-opioid agonist, can cause choreiform hyperkinesias and euphoria, even in patients with prior substance abuse. These transient movement abnormalities and EEG changes highlight potential neurobiological effects of methadone.
Area of Science:
- Neuropharmacology
- Movement Disorders
Background:
- Choreiform hyperkinesias are documented with cocaine intoxication but not typically with opiate use.
- Opioid medications, particularly selective mu-opioid agonists like methadone, are widely used for pain management and opioid use disorder treatment.
Observation:
- A case report details a patient experiencing euphoria and choreoathetoid movements.
- These symptoms emerged during rapid dose adjustment of methadone.
- The patient had a history of heroin and cocaine abuse.
Findings:
- Transient choreoathetoid movements and euphoria were induced by methadone.
- Minor electroencephalogram (EEG) abnormalities were also observed.
- This suggests a potential neurobiological link between methadone and hyperkinetic movements.
Implications:
- This case expands the understanding of potential adverse effects of methadone beyond typical opioid side effects.
- It prompts further investigation into the neurobiological mechanisms underlying methadone-induced movement abnormalities.
- Clinicians should be aware of the possibility of hyperkinesias in patients on methadone, especially those with a history of polysubstance abuse.