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Published 10 May 2009
Cite this as: BMJ Case Reports 2009 [doi:10.1136/bcr.11.2008.1268]
Copyright © 2009 by the BMJ Publishing Group Ltd.

Unexpected outcome (positive or negative) including adverse drug reactions

Gabapentin toxicity: an important cause of altered consciousness in patients with uraemia

T Y Hung1, V K Seow1, C F Chong1,2, T L Wang1,2, C C Chen1,2

1 Emergency Department, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
2 School of Medicine, Fu Jen Catholic University, Taipei, Taiwan

Correspondence to:
C C Chen, timshel{at}ms67.hinet.net

SUMMARY

Gabapentin toxicity should be considered one of the differential diagnoses of altered consciousness in patients with compromised renal function, even after a single dose. We report a 57-year-old woman with diabetes mellitus and uraemia on regular haemodialysis who developed severe dizziness and lethargy after a single recommended dose of gabapentin for bilateral leg dysthesia. Because of progressive drowsiness and decreasing level of consciousness, one session of haemodialysis was performed and clinical recovery was dramatic. The adverse effects of gabapentin seem to vary from person to person and should be viewed with a high degree of suspicion, especially in patients taking this drug at the beginning.


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