Ghaly Ramsis F, Plesca Ana, Rana Shalini, Candido Kenneth D, Knezevic Nebojsa Nick
Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, Illinois, USA.
Ghaly Neurosurgical Associates, Aurora, Chicago, Illinois, USA.
Surg Neurol Int. 2018 Oct 23;9:210. doi: 10.4103/sni.sni_420_17. eCollection 2018.
The opioid epidemic in America is real and is estimated to be the number one cause of death in adults under 50 years of age. Finding alternative analgesic medications is part of the effort to decrease the prescription of narcotics, with gabapentin being at the top of the list.
In the present case, we discuss the side-effects of gabapentin, used as part of the multimodal treatment approach of painful spinal degenerative disease. The patient stated that he had noticed personality changes after gabapentin was initiated, and that he had become more depressed, frustrated, and aggressive. His uncontrolled pain and acute mood changes led him to attempt suicide by hanging himself. Gabapentin was discontinued and the patient's suicidal ideation completely subsided.
It is imperative to screen, identify, and appropriately manage patients with underlying psychiatric disorders prior to initiating pain management with gabapentin. Therefore, it is crucial to raise awareness of gabapentin as a potential cause of depression, aggressive behavior, and suicidal ideation.
美国的阿片类药物泛滥问题确实存在,据估计是50岁以下成年人的首要死因。寻找替代镇痛药物是减少麻醉药品处方努力的一部分,加巴喷丁位居榜首。
在本病例中,我们讨论了作为疼痛性脊柱退行性疾病多模式治疗方法一部分使用的加巴喷丁的副作用。患者表示,在开始使用加巴喷丁后他注意到了性格变化,并且变得更加抑郁、沮丧和有攻击性。他无法控制的疼痛和急性情绪变化导致他试图上吊自杀。停用加巴喷丁后,患者的自杀念头完全消退。
在用加巴喷丁进行疼痛管理之前,必须对有潜在精神疾病的患者进行筛查、识别并进行适当管理。因此,提高对加巴喷丁作为抑郁、攻击行为和自杀念头潜在原因的认识至关重要。