title: Myoclonus in renal failure: Two cases of gabapentin toxicity.
abstract: Gabapentin, an AED approved for the adjunctive treatment of partial seizures with/without secondary generalization and for the treatment of postherpetic neuralgia, is frequently used off-label for the treatment of both psychiatric and pain disorders. Since gabapentin is cleared solely by renal excretion, dosing requires consideration of the patient's renal function. Myoclonic activity may occur as a complication of gabapentin toxicity, especially with acute kidney injury or end-stage renal disease. We report 2 cases of myoclonic activity associated with gabapentin toxicity in the setting of renal disease which resolved with discontinuation of gabapentin and treatment with hemodialysis and peritoneal dialysis. As gabapentin has multiple indications and off-label uses, an understanding of myoclonus, neurotoxicity, and renal dosing is important to clinicians in multiple specialties.
authors: Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, USA ; Department of Neurology, Rutgers Robert Wood Johnson Medical School, USA ; Department of Anesthesiology, Rutgers Robert Wood Johnson Medical School, USA.
authors: Kenneth R
authors: KR
authors: Kaufman
authors: Department of Internal Medicine, Rutgers Robert Wood Johnson Medical School, USA.
authors: Amay
authors: A
authors: Parikh
authors: Department of Internal Medicine, Rutgers Robert Wood Johnson Medical School, USA.
authors: Lili
authors: L
authors: Chan
authors: Department of Pharmacy Practice and Administration, Rutgers Ernest Mario School of Pharmacy, USA.
authors: Mary
authors: M
authors: Bridgeman
authors: Pharmaceutical Services, West Virginia University Healthcare, USA.
authors: Milisha
authors: M
authors: Shah
keywords: Acute kidney injury; Antiepileptic drug; Diabetic peripheral neuropathic pain; Education; End-stage renal disease; Gabapentin; Hemodialysis; Myoclonus; Peritoneal dialysis; Toxicity