• PDF / 141,791 Bytes
• 1 Pages / 595.245 x 841.846 pts (A4) Page_size
• 33 Downloads / 205 Views

DOWNLOAD

REPORT

---

1

Amitriptyline/gabapentin/pregabalin Falls, dizziness and drowsiness in elderly patients: 3 case reports Three cancer patients with neuropathic pain experienced episodes of falls while receiving treatment with gabapentin, amitriptyline or pregabalin [routes not stated]; in addition, two patients developed drowsiness, with one of these also experiencing dizziness. A 69-year-old woman commenced gabapentin 300 mg/day, with a gradual increase to 3600 mg/day over 2 weeks. After 5 weeks of gabapentin, she had developed walking instability, with three falls over the last month. Her neuropathic pain had not improved. As gabapentin was thought to have caused the falls, it was withdrawn. She had no further episodes of falling. A 71-year-old man started amitriptyline 10mg at night; however his pain persisted, requiring two dosage increases to 50mg per night. On day 10, he had severe drowsiness and a ’heavy head’. In addition, his neuropathic pain had not improved. He was then switched to pregabalin 75mg twice daily. One week later, he developed dizziness, with a tendency to fall, and his drowsiness had returned. After 2 weeks of pregabalin, he was almost incapable of walking, and pregabalin was stopped. His dizziness gradually reduced over the next 4 weeks. He subsequently refused any further treatment for his neuropathic pain. A 69-year-old man was prescribed amitriptyline 10mg at night. Two days later, he developed drowsiness and concentration problems. His drowsiness caused him to fall from his bicycle; however, he decided that the side effects were acceptable and elected to continue treatment. His drowsiness gradually subsided. After 1 month of treatment, amitriptyline was increased to 25mg at night, with no increase in side effects. Author comment: According to the Naranjo scale, there was a ’probable’ connection between each drug and the side effects that occurred. Schalkwijk A, et al. Pitfalls in the treatment of neuropathic pain in patients with cancer. Nederlands Tijdschrift voor Geneeskunde 155: 345-349, No. 8, Feb 2011 803062460 [Dutch; summarised from a translation] - Netherlands

0114-9954/10/1377-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved

Reactions 12 Nov 2011 No. 1377