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1 results

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

  • Enrica Di Rosa, Antonio E. Di Rosa
  • Journal:
    Acta Neuropsychiatrica / Volume 26 / Issue 1 / February 2014
    Published online by Cambridge University Press:
    08 October 2013, pp. 58-60
  • 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.