Gabapentin for Behavioral Dyscontrol With Mental Retardation
Ms. A was a 23-year-old woman who suffered from profound mental retardation due to Cornelia de Lange syndrome. She had severely limited motor and communication skills (speaking few and isolated words), difficulties adapting to environmental changes, and inadequate sphincter control.Maladaptive behavior had appeared for the first time when she was 18 years old. She had been treated as an outpatient and given oral risperidone, 1 mg/day, and diazepam, 5 mg/day, resulting in significant remission of her symptoms. Three years later, agitation, hostility, self-destructive behavior, and screaming had reemerged and had been unsuccessfully treated on an outpatient basis with increases in her medication doses (up to 4 mg/day of risperidone and 30 mg/day of diazepam). Finally, 4 months later, Ms. A was admitted to our psychiatric clinic, but despite the alteration of her medications, her condition remained unchanged. Her last drug regimen included 5 mg t.i.d. of orally administrated haloperidol drops, 25 mg t.i.d. of chlorpromazine, and 4 mg b.i.d. of extended-release biperidin; lorazepam, 2 mg given intramuscularly, was used on an as-needed basis.Oral gabapentin, 400 mg/day, was added, and after a few days it was increased to 800 mg b.i.d. As a result, a remarkable improvement was noticed. All drugs were gradually tapered, and Ms. A’s medications were adjusted to 5 mg/day of haloperidol, 400 mg/day of gabapentin, and 4 mg/day of extended-release biperiden without any aggravation of her symptoms. When gabapentin was withdrawn, Ms. A’s behavioral dyscontrol reemerged within 48 hours. Gabapentin, 400 mg/day, was reintroduced, resulting again in improvement. Haloperidol was further tapered to a dose of 3 mg/day, and biperidin was completely withdrawn. No further changes were made in Ms. A’s drug regimen, because her condition was considered satisfactory. Four months after discharge, Ms. A’s clinical condition has remained stable.
References
Information & Authors
Information
Published In
History
Authors
Metrics & Citations
Metrics
Citations
Export Citations
If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.
For more information or tips please see 'Downloading to a citation manager' in the Help menu.
There are no citations for this item
View Options
View options
PDF/ePub
View PDF/ePubGet Access
Login options
Already a subscriber? Access your subscription through your login credentials or your institution for full access to this article.
Personal login Institutional Login Open Athens loginNot a subscriber?
PsychiatryOnline subscription options offer access to the DSM-5-TR® library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.
Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).