Pregabalin-Induced Parkinsonism

Abstract

: Pregabalin (PGB) is an L-type, voltage-dependent, calcium-channel blocker, useful for the treatment of neuropathy pain and some forms of seizures. We report the case of a 64-year-old woman who developed full-blown parkinsonism after PGB administration. : A female patient who developed diabetic sensory-motor polyneuropathy began treatment with gabapentin 300 mg plus amitriptyline 25 mg at the age of 56 years, with good tolerance. Eight years later, PGB 150 mg was added, after 3 months she developed a parkinsonian-like syndrome with axial symptoms, bilateral symmetric postural tremor, bradykinesia, and rigidity in both upper and lower limbs. Unified Parkinson's Disease Rating Scale motor score was 27/108 points at this time. Clear link to PGB introduction as well as symmetric limb involvement and symptom intensity made us suspect drug-induced parkinsonism. Pregabalin was withdrawn. Six months later, the patient had almost completely recovered; her Unified Parkinson's Disease Rating Scale motor score dropped to 4/108; and 3 months after that, it was 0. : Although some cases of tremor were reported in clinical trials on PGB, to our knowledge, this is the first report of full-blown parkinsonism associated with PGB use. Vigilance of PGB-treated patients is recommended.