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Loperamide overdose-induced catatonia: potential role of brain opioid system and P-glycoprotein

  • Enrica Di Rosa (a1) and Antonio E. Di Rosa (a2)
Abstract
Objective

Catatonic features are observed in several psychiatric illnesses but can also be found following substance misuse. Loperamide is an anti-diarrhoeal medication that acts on opioid receptors in the intestine, reducing peristalsis. It is normally unable to pass through the intestinal wall or the blood–brain barrier; however, high dosages can in fact induce the effects on the central nervous system.

Case report

We describe the case of a 20-year-old man who presented with severe catatonia following excessive intake of loperamide, fully remitted with lorazepam.

Conclusion

We speculate on a possible increase of loperamide's bioavailability after overdose owing to reduced expression and functioning of P-glycoprotein.

Copyright
Corresponding author
Enrica Di Rosa, Department of Clinical and Experimental Medicine and Pharmacology, University of Messina, Policlinico Universitario, via Consolare Valeria, 1, 98125 Messina, Italy. Tel: +00393333992601; Fax: +0039090695136; E-mails: edirosa@unime.it, enricadirosa@tiscali.it
References
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Acta Neuropsychiatrica
  • ISSN: 0924-2708
  • EISSN: 1601-5215
  • URL: /core/journals/acta-neuropsychiatrica
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