Chorea associated with gabapentin use in an elderly man.
BACKGROUND
Chorea is a hyperkinetic movement disorder characterized by irregular, flowing, nonstereotyped, random, involuntary movements. Huntington disease (HD) and drug-induced chorea account for >50% of adult-onset cases. Chorea associated with gabapentin, an anticonvulsant, has not been well documented.


OBJECTIVE
The purpose of this article was to report a case of chorea that developed in an elderly man being treated with gabapentin for severe anxiety.


METHODS
A 75-year-old white man (height, 165.1 cm; weight, 65.8 kg; body mass index, 19.6 kg/m2) with anxiety disorder not otherwise specified was admitted to a geriatric medicine psychiatric unit in Connecticut because of worsening symptoms of anxiety affecting his cognitive ability. On evaluation, the patient had choreiform movements involving the neck, trunk, upper and lower extremities, and tongue. The patient reported that symptoms began after taking gabapentin 300 mg PO TID (prescribed by his geriatrician) for the treatment of anxiety. The patient had been taking gabapentin for >1 month when the symptoms first appeared. There was no known family history of HD, and patient workup was unremarkable for other conditions (eg, vascular disease of the brain, progressive dementia, infectious and metabolic disorders) that might present with chorea. The chorea lasted for ~4 months and resolved within 2 days after gabapentin discontinuation.


CONCLUSIONS
This article reports a case of chorea in an elderly patient who was receiving gabapentin for the treatment of anxiety. After gabapentin discontinuation, the chorea resolved completely, indicating a probable adverse drug reaction.
Attupurath
Reji
R
Department of Psychiatry, Richmond University Medical Center, Staten Island, New York 10310, USA.
Aziz
Rehan
R
Wollman
Daniel
D
Muralee
Sunanda
S
Tampi
Rajesh R
RR
D000368:Aged; D000588:Amines / Q000009:adverse effects* / Q000627:therapeutic use; D000700:Analgesics / Q000009:adverse effects* / Q000627:therapeutic use; D018726:Anti-Dyskinesia Agents / Q000627:therapeutic use; D001007:Anxiety / Q000188:drug therapy / Q000523:psychology; D002819:Chorea / Q000139:chemically induced* / Q000188:drug therapy; D003072:Cognition Disorders / Q000188:drug therapy / Q000523:psychology; D003509:Cyclohexanecarboxylic Acids / Q000009:adverse effects* / Q000627:therapeutic use; D000077206:Gabapentin; D006220:Haloperidol / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008569:Memory Disorders / Q000188:drug therapy / Q000523:psychology; D009483:Neuropsychological Tests; D005680:gamma-Aminobutyric Acid / Q000009:adverse effects* / Q000627:therapeutic use
D000588:Amines; D000700:Analgesics; D018726:Anti-Dyskinesia Agents; D003509:Cyclohexanecarboxylic Acids; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D006220:Haloperidol