Significant pregabalin toxicity managed with supportive care alone.

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Wood DM, Berry DJ, Glover G, Eastwood J, Dargan PI

Significant pregabalin toxicity managed with supportive care alone.

J Med Toxicol. 2010 Dec;6(4):435-7. doi: 10.1007/s13181-010-0052-3.

PubMed ID
20373065 [ View in PubMed
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Abstract

There are two previously reported cases describing the management of pregabalin self-poisoning and one further case of management of therapeutic pregabalin accumulation. The peak reported pregabalin concentrations in these cases ranged from 13 mg/L to approximately 60 mg/L. Previous case reports have suggested that both supportive care and enhanced elimination are appropriate managements for pregabalin toxicity. A 54-year-old male presented following ingestion of 8.4 g of pregabalin. Initially, he had no clinical features of toxicity, although he developed significant neurological depression and coma approximately 3 h post-ingestion. He was managed with supportive care (including endotracheal intubation and mechanical ventilation) until his level of consciousness improved. Subsequent toxicological screening confirmed isolated pregabalin ingestion, with a serum pregabalin concentration of 66.5 mg/L at the time he clinically deteriorated. The pharmacokinetic properties of pregabalin indicate the potential value of extra-corporeal elimination methods such as haemodialysis. Clinical toxicologists should be aware that whilst there is a pharmacokinetic basis for the use of extra-corporeal methods in those with severe toxicity arising from excessive plasma pregabalin concentrations, there are case reports, including this one, where patients have been managed with supportive measures only.

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