Reactions 1704, p261 - 2 Jun 2018
O S
Multiple drugs
Various toxicities: 10 case reports
A case report originating from the centre of evaluation and
information on pharmacodependence-addictovigilance of
Paris described ten patients (seven men and three women),
aged 25
–
84 years, who developed dependence to
mephenesin; most of these patients were abusing mephenesin
at an overdose. Four of ten patients also developed
dependence to alprazolam, zolpidem, promethazine,
doxylamine, codeine or bromazepam. Three of ten patients
developed sleep disorder, anxiety, agitation, tremor or
irritability following the withdrawal of mephenesin [routes,
durations of treatments to reaction onsets and outcomes not
stated, not all dosages and indication stated].
The patients had a history of depression, alcoholism, high
BP, chronic obstructive pulmonary disease, fractured
collarbone, capsulitis, sleep disorder, lumbar pain, childhood
maltreatment, discal hernia, arthrosis, scoliosis, eating
disorders, medication overuse headache, back pain or physical
disability. Additionally, in six of the 10 patients, history was
significant for alcoholism, overweight, gambling, illicit drugs
use, alcohol abuse or cannabis use. The social history was
significant for only tobacco (three patients), only alcohol (one
patient) and both alcohol and tobacco (two patients). Seven of
the ten patients were also receiving current medications. All
the patients received mephenesin and dose was
1
–
144 gram/day for a duration of 3 months
–
6 years
(8 patients). Six of the 10 patients were using mephenesin to
seek effect such as sedation, anxiolytic, hypnotic, sensation of
well-being, analgesic or anti-craving for alcohol. Thereafter,
eight of the 10 patients, met the criteria for diagnostic and
statistical manual of mental disorders fifth edition for
substance-related and addictive disorders, while in two
patients it was unknown for mephenesin. The treatment with
mephenesin was discontinued in all the patients. In three of
the 10 patients developed sleep disorder (n=1), anxiety,
agitation, sleep disorder and tremor (n=1) and anxiety, tremor
and irritability (n=1) following the withdrawal of mephenesin.
In four the 10 patients multiple drug dependence was noted, of
which two patients were also dependent on alprazolam, one
patient on zolpidem, promethazine and doxylamine and
remaining one patient on codeine and bromazepam.
Author comment: "[W]e reported 10 new clinical cases of
mephenesin use disorder collected between 2012 and 2017."
"Four patients presented multiple drug dependence."
Chevallier C, et al. Mephenesin: Is There a Progression in Cases of Substance Use
Related Disorders in France?. Journal of Clinical Psychopharmacology 38:
275-277, No. 3, Jun 2018. Available from: URL: http://doi.org/10.1097/
JCP.0000000000000884 - France
803323796
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