Gabapentin or pregabalin induced myoclonus: A case series and literature review

Desai, Aaron; Kherallah, Yazan; Szabo, Cheryl; Marawar, Rohit

doi:10.1016/j.jocn.2018.09.019

Cited by 32 publications

(14 citation statements)

References 32 publications

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“…No increase in GTC seizure rate was seen, and the safety profile of pregabalin in this new population of patients was in line with previous observations of adjunctive pregabalin treatment for FOS, in both children and adults 17,18,21,22,24 . While some reports suggest an increase of myoclonic seizures in patients taking pregabalin, 28‐30 this was not observed herein for either dose of pregabalin. It is important to note, however, that this study was not powered to detect differences in seizure type, other than GTC seizures.…”

Section: Discussionsupporting

confidence: 90%

Pregabalin as adjunctive therapy in adult and pediatric patients with generalized tonic‐clonic seizures: A randomized, placebo‐controlled trial

et al. 2021

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Section: Discussionsupporting

confidence: 90%

Pregabalin as adjunctive therapy in adult and pediatric patients with generalized tonic‐clonic seizures: A randomized, placebo‐controlled trial

et al. 2021

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“…For the years 1999 and 2019, a total of 46 reports containing 305 cases who developed MDs after the use of PGB from 17 different countries were reported [ Table 1 ]. [ 2 3 10 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 ] The origin was North American in 196, European in 68, Asian in 40, and South American in 1. The MDs associated with PGB found were as follows: 184 patients with ataxia, 61 with tremors, 39 with MCL, 8 with parkinsonism, 1 with restless legs syndrome, 1 with dystonia, 1 with dyskinesia, and 1 with akathisia.…”

Section: Resultsmentioning

confidence: 99%

“…They concluded that drug-resistant epilepsy, higher PGB doses, and renal impairment were risk factors for the development of MCL. [ 24 ] We believe that none of these risk factors are highly associated with MCL secondary to PGB, but they could be related to the gabapentin use. Based on our records, the percentage of patients with drug-resistant epilepsy who developed MCL after the use of PGB was only 20% (8/39).…”

Section: Discussionmentioning

confidence: 99%

Pregabalin-associated movement disorders: A literature review

Rissardo

Caprara

2020

Brain Circ

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Central nervous system adverse effects are commonly reported with pregabalin (PGB). On the other hand, movement disorders (MDs) associated with this drug were rarely described. However, their occurrence could significantly affect the quality of life of PGB users. This literature review aims to evaluate the clinical epidemiological profile, pathological mechanisms, and management of PGB-associated MDs. Relevant reports in six databases were identified and assessed by two reviewers without language restriction. A total of 46 reports containing 305 cases from 17 countries were assessed. The MDs encountered were as follows: 184 individuals with ataxia, 61 with tremors, 39 with myoclonus, 8 with parkinsonism, 1 with restless legs syndrome, 1 with dystonia, 1 with dyskinesia, and 1 with akathisia. The mean age was 62 years (range: 23–94). The male sex was slightly predominant with 54.34%. The mean PGB dose when the MD occurred was 238 mg, and neuropathic pain was the most common indication of PGB. The time from PGB start to MD was < 1 month at 75%. The time from PGB withdrawal to recovery was < 1 week at 77%. All the individuals where the follow-up was reported had a full recovery. The most common management was PGB withdrawal. In the literature, the majority of the cases did not report information about timeline events, neurological examination details, or electrodiagnostic studies. The best management for all MDs is probably PGB withdrawal. If the patient is on dialysis program, perhaps an increased number of sessions will decrease recovery time. Furthermore, the addition of a benzodiazepine could accelerate recovery.

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“…One of them, Propoxazepam, 7-bromo-5-(o-chlorophenyl)-3-propoxy-1,2-dihydro-3H-1,4-benzodiazepin-2-one, is considered a promising drug and is undergoing preclinical trials [6]. Similar to gabapentin and pregabalin, which are well-known drugs used in general medical practice in the treatment of neuropathic pain [7], propoxazepam also has an anticonvulsant effect [8,9], which explains the analgesic component of the pharmacological spectrum…”

Section: Introductionmentioning

confidence: 99%

Evidence for the involvement of the GABA- ergic pathway in the anticonvulsant and antinociception activity of Propoxazepam in mice and rats

Glovenko

Reder

Андронати

et al. 2019

J Pre Clin Clin Res.

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Introduction. Propoxazepam (3-alcoxyderivative of 1.4-benzodiazepine), in the tail-flick test and picrotoxin-induced convulsions showed significant analgesic and antiepileptic activity. Flumazenil (GABA antagonist) reduced its analgesic action, although antiseizure activity was changed slightly. As specific propoxazepam actions are anticonvulsant (1 subtype GABAA-R) and analgesic (2 subtype GABAA-R in the spinal cord), it can be suggested that the substance has no abuse-related side-effects. Materials and method. The possible involvement of the GABA system in the antinociceptive effect of propoxazepam was examined by administering flumazenil (1 and 10 mg/kg, i.p.), a selective GABA-receptor antagonist, 30 min prior to propoxazepam (1.8 and 10 mg/kg, orally) in rats. Picrotoxin solution (6.5 mg/kg, 95 % of lethality effect in mice) was injected subcutaneously 30 min after propoxazepam administration. Flumazenil was administered intraperitoneally 0.5 hour prior to propoxazepam administration. Time counting was starting from the convulsant injection and during the supervision time, the number of myoclonic convulsions and tonic extensia, time of their onset, as well as time to lethal effect (survival time), were registered. Results. Flumazenil and propoxazepam antiseizure effect in the picrotoxin-induced seizures test were estimated as 5.24±2.38 and 0.37±0.07 mg/kg. Antiseizure effect of propoxazepam was reduced with flumazenil administration. Flumazenil (1 mg/ kg) had no effect in tail-flick test but abolished the antinociceptive action of propoxazepam (tail flick latency period changes were-1.6% and +55.1, compared to control and propoxazepam alone administration, respectively). Conclusions. The mechanism of propoxazepam antiseizure and antinociceptive actions are GABA-R determined. Analgesic action mechanism assumes additional biotargets involvement.

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Gabapentin or pregabalin induced myoclonus: A case series and literature review

Cited by 32 publications

References 32 publications

Pregabalin as adjunctive therapy in adult and pediatric patients with generalized tonic‐clonic seizures: A randomized, placebo‐controlled trial

Pregabalin as adjunctive therapy in adult and pediatric patients with generalized tonic‐clonic seizures: A randomized, placebo‐controlled trial

Pregabalin-associated movement disorders: A literature review

Evidence for the involvement of the GABA- ergic pathway in the anticonvulsant and antinociception activity of Propoxazepam in mice and rats

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