Bir depresyon hastasında gabapentin yoksunluğu: Olgu sunumu

Gabapentin santral sinir sisteminin önemli bir nörotransmitteri olan gamma amino bütirik asitin (GABA) yapısal analoğu üçüncü kuşak bir antiepileptiktir. Parsiyel epilepsi, nöropatik ağrı ve hareket bozuklukları tedavisinin yanı sıra bipolar bozukluk, anksiyete bozukluğu ve alkol bağımlılığı gibi psikiyatrik hastalıkların tedavisinde kullanıldığını bildirilmiştir. Günümüzde kötüye kullanım ve bağımlılık potansiyeli olduğu da kabul edilmektir. Olgu sunumumuzda depresyon tanısı ile izlenen ve üç yıl önce geçirdiği vertebra cerrahisine bağlı olarak gelişen nöropatik ağrılar nedeniyle yüksek doz gabapentin kullanan bir kadın hastada, gabapentinin kesilmesiyle birlikte ortaya çıkan yoksunluk belirtilerini ve tedavi sürecini ele aldık. Gabapentin yoksunluğunda tanımlanan değişen şiddetteki belirtiler tedavinin doz azaltılarak ve ayları bulan uzun süre içinde sonlandırılmasının önemini ortaya koymaktadır. Gabapentin çekilme belirtileri varlığında predispozan etkenler dikkate alınmalı, melatonin ve mirtazapinin bir tedavi alternatifi olarak düşünülebileceği akılda bulundurulmalıdır. (Anadolu Psikiyatri Derg 2016; 17(Ek.3):61-63).

Gabapentin withdrawal in a depressed patient: A case report

The third generation antiepileptic, gabapentin, is a structural analogue of gamma aminobutyric acid (GABA), which is an important neurotransmitter of central nervous system. It is used to treat partial epilepsy, neuropathic pain, and movement disorders, as well as a variety of psychiatric conditions such as bipolar disorder, anxiety disorder, and alcohol addiction. Currently it is accepted to possess a potential for abuse and addiction. In this study, we present a case of a woman with depression who had been using a high dose gabapentin treatment for neuropathic pain due to spinal surgery performed 3 years before. Here, we highlight the withdrawal symptoms following the termination of gabapentin, and their treatment. The symptoms of varying severity in gabapentin withdrawal underline the importance of progressively decreasing the dose on a schedule of several months before ceasing the drug completely. Predisposing factors should be noted, and alternative treatment options like melatonin and mirtazapine should be considered. (Anatolian Journal of Psychiatry 2016; 17(Suppl.3):61-63).

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