TY  - JOUR
PY  - 2011//
TI  - Increased risk of suicide under intrathecal ziconotide treatment? - A warning
JO  - Pain
A1  - Maier, Christoph
A1  - Gockel, Hans-Helmut
A1  - Gruhn, Kai
A1  - Krumova, Elena K.
A1  - Edel, Marc-Andreas
SP  - 235
EP  - 237
VL  - 152
IS  - 1
N2  - Despite some other known psychiatric adverse effects, ziconotide is recommended for intrathecal pain treatment with a good efficacy and safety. Although some hints in previous studies are apparent, a higher suicidality has not been accepted as a treatment risk of ziconotide treatment by the investigators in the former randomized controlled trials so far. We present two cases supporting the suspicion of ziconotide-induced suicidality. Both showed no depressive symptoms at the time of treatment initiation. One patient performed suicide under low-dose (cumulative dosage: 779μg) 4weeks after the onset of intrathecal ziconotide treatment despite sufficient pain relief. Another female patient with a history of depression, but free of symptoms under antidepressive medication since more than 15years, developed severe suicidal ideation 2months after ziconotide treatment (cumulative dosage: about 2900μg) with rapid recovery after drug discontinuation. The patient, who has completed suicide, had earlier given rise to discuss a potential depressive disorder, however, this diagnosis was scrapped, but the second patient had a clear history of depression. These cases substantiate the suspicion of a causal relationship between ziconotide and suicidality even in symptom-free patients with a history of depression. Therefore, a comprehensive psychiatric evaluation is unavoidable before and during ziconotide treatment.<p />  <p>Language: en</p>
LA  - en
SN  - 0304-3959
UR  - http://dx.doi.org/10.1016/j.pain.2010.10.007
ID  - ref1
ER  -