Gabapentin-Associated Movement Disorders: A Literature Review

Abstract

Background: Gabapentin (GBP)-induced movement disorders (MDs) are under-recognized adverse drug reactions. They are commonly not discussed with patients, and their sudden occurrence can lead to misdiagnosis. This literature review aims to evaluate the clinical–epidemiological profile, pathological mechanisms, and management of GBP-associated MD. Methods: Two reviewers identified and assessed relevant reports in six databases without language restriction between 1990 and 2023. Results: A total of 99 reports of 204 individuals who developed a MD associated with GBP were identified. The MDs encountered were 135 myoclonus, 22 dyskinesias, 7 dystonia, 3 akathisia, 3 stutterings, 1 myokymia, and 1 parkinsonism. The mean and median ages were 54.54 (SD: 17.79) and 57 years (age range: 10–89), respectively. Subjects were predominantly male (53.57%). The mean and median doses of GBP when the MD occurred were 1324.66 (SD: 1117.66) and 1033 mg/daily (GBP dose range: 100–9600), respectively. The mean time from GBP-onset to GBP-associated MD was 4.58 weeks (SD: 8.08). The mean recovery time after MD treatment was 4.17 days (SD: 4.87). The MD management involved GBP discontinuation. A total of 82.5% of the individuals had a full recovery in the follow-up period. Conclusions: Myoclonus (GRADE A) and dyskinesia (GRADE C) were the most common movement disorders associated with GBP.

Advances in Understanding and Managing Movement Disorders: A Comprehensive Review

“…It can be caused by a variety of factors, including neurological conditions, metabolic disorders, and medication side effects. Interestingly, myoclonus was already reported with pregabalin [27] and gabapentin [28].…”

A Literature Review of Movement Disorder Associated with Medications and Systemic Diseases

“…While it is generally well-tolerated, movement disorders are not commonly associated with gabapentin use [55]. Movement disorders can encompass a range of conditions, including tremors, dystonia, and ataxia [56]. While some medications may cause movement disorders as side effects, gabapentin is not typically known for inducing these types of issues.…”

Flapping Tremor: Unraveling Asterixis—A Narrative Review

“…The occurrence of asterixis can be attributed to the direct effect of the drug on the CNS and the indirect effect ( Table 6 ) [ 7 , 70 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 ]. The direct effect can be explained by abnormalities in the neurotransmitter levels and toxic levels of the medications.…”

“…In individuals with chronic renal failure, gabapentin dosage should be carefully increased. There are reports of gabapentin intoxication presenting with asterixis before other neurological symptoms [ 82 ]. Lithium [ 89 ] and amantadine [ 79 ] are other medications associated with asterixis.…”