Drug points: Near fatal auditory hallucinations after buprenorphine

Paraskevaides, E. C.

doi:10.1136/bmj.296.6616.214-b

Cited by 15 publications

(7 citation statements)

References 6 publications

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“…Keeley et al 52 Gordon 26 Keshavan et al 43 Gordon et al 75 Kobayashi et al 63 Prommer 56 Lennox 71 Stephane et al 68 Marneros et al 73 Moore 30 Murata et al 37 Nagaratnam et al 42 Paraskevaides 55 Rennie 46 Roberts et al 41 Rozanski and Rosen 29 Schielke et al 38 Stephane and Hsu 33 Tanriverdi et al 32 Terao and Tani 72 Ukai et al 74 Wengel et al 19 Wales. From this, they computed a referral rate of one case of clinically significant MH per year, per 10 000 individuals over 65 years of age.…”

Section: Katz 54 Lettersmentioning

confidence: 99%

“…A number of medications have been linked with MH, 51 although none as strongly as opioids; cases have been reported with tramadol, 52 morphine sulphate, 53 and oxycodone. 30 Opioids have also been linked with nonmusical auditory hallucinations, 54,55 but here pre-existing psychiatric disorders are commonly present. It has been proposed that, as well as central actions, there is a direct cochlear contribution to this phenomenon.…”

Section: Pharmacologymentioning

confidence: 99%

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Is musical hallucination an otological phenomenon? a review of the literature

Cope

Baguley

2009

Clinical Otolaryngology

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This review supports the proposal that the otological system plays a role in the pathogenesis of musical hallucination. Hearing impairment may act as an initiating factor, and the primary dysfunction is overactivity of auditory association cortex, although an impairment of higher-level inhibition does also seem necessary. Once underlying sinister causes have been excluded, first line treatment should be explanation of the condition and optimisation of hearing. Medications have a role only in selected patient groups.

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Section: Katz 54 Lettersmentioning

confidence: 99%

Section: Pharmacologymentioning

confidence: 99%

Is musical hallucination an otological phenomenon? a review of the literature

Cope

Baguley

2009

Clinical Otolaryngology

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“…44 Another case report described near fatal auditory hallucinations because of suicidal ideation after receiving a single dose of sublingual buprenorphine. 45 Subsequent case reports have additionally reported tactile, visual, and auditory hallucinations with chronic intravenous administration. 46,47 Neurotoxicity appears to be related to the accumulation of buprenorphine metabolites, N - desalkyl buprenorphine and buprenorphine-3-O-glucuronide.…”

Section: Resultsmentioning

confidence: 99%

Opioid-induced Hallucinations: A Review of the Literature, Pathophysiology, Diagnosis, and Treatment

Sivanesan

Gitlin

Candiotti

2016

Anesthesia &Amp; Analgesia

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Despite their association with multiple adverse effects, opioid prescription continues to increase. Opioid-induced hallucination is an uncommon yet significant adverse effect of opioid treatment. The practitioner may encounter patient reluctance to volunteer the occurrence of this phenomenon because of fears of being judged mentally unsound. The majority of the literature concerning opioid-induced hallucinations arises from treatment during end-of-life care and cancer pain. Because the rate of opioid prescriptions continues to increase in the population, the rate of opioid-associated hallucinations may also conceivably increase. With a forecasted increase in the patient-to-physician ratio, opioid therapy is predicted to be provided by practitioners of varying backgrounds and medical specialties. Hence, knowledge of the pharmacology and potential adverse effects of these agents is required. This review seeks to increase awareness of this potential complication through a discussion of the literature, potential mechanisms of action, diagnosis, and treatment strategies.

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“…While it is well known that the administration of opioid analgesics can produce hallucinations [7][8][9][10][11][12][13][14][15][16][17][18][19], we are the first to report such a phenomenon in a case of VCFS and Madelung deformity. This finding is particularly intriguing in that the hallucinations could be evoked by multiple opioid agents in a reliable and repeatable manner.…”

Section: Discussionmentioning

confidence: 98%

“…Opioid administration may be required for treatment of moderate to severe pain, and this administration can be associated with neuroexcitatory phenomena including agitation, paranoia, delirium, hyperreflexia, tremors, seizures, and auditory and visual hallucinations [7][8][9][10][11][12][13][14][15][16][17][18][19]. Populations at a higher presumed risk include the elderly, those with preexisting borderline cognition, protracted opioid treatment at high dosages, chronic renal insufficiency, and concomitant administration of psychoactive medications [18,19].…”

mentioning

confidence: 99%

Does Dysregulation of Catechol-O-Methyltransferase Predispose to Opioid-Induced Hallucinations? A Report of a Patient with Microdeletion of Chromosome 22 and Opioid-Associated Hallucinations

Gitlin¹,

Taylor

Kalarickal³

et al. 2007

Pain Med

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Velocardiofacial syndrome is a genetic disorder associated with a microdeletion on the long arm of chromosome 22, and this segment is responsible for coding catechol-O-methyltransferase, an enzyme involved in dopamine degradation. We submit a case of velocardiofacial syndrome and Madelung deformity of the wrists presenting with hallucinatory phenomena associated with opioid exposure. Overactivity of the dopaminergic system has been postulated to cause schizophrenia in this population, and here we speculate that dysregulation of dopamine metabolism may have predisposed our patient to an increased risk of opioid-induced hallucinations. Further research is necessary to explore this relationship.

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Drug points: Near fatal auditory hallucinations after buprenorphine

Cited by 15 publications

References 6 publications

Is musical hallucination an otological phenomenon? a review of the literature

Is musical hallucination an otological phenomenon? a review of the literature

Opioid-induced Hallucinations: A Review of the Literature, Pathophysiology, Diagnosis, and Treatment

Does Dysregulation of Catechol-O-Methyltransferase Predispose to Opioid-Induced Hallucinations? A Report of a Patient with Microdeletion of Chromosome 22 and Opioid-Associated Hallucinations

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