Health & body · 2023
Can stopping during a hospital stay be followed by serious withdrawal symptoms in someone without Parkinson's disease?
Yes—in this case report, a man with spinocerebellar ataxia and no Parkinson's disease developed fever, a rapid heart rate, mild limb rigidity and markedly reduced alertness after his oral medications were held. His vital signs and encephalopathy improved within 2 days of restarting amantadine.
Details
This single-patient case report describes a man with spinocerebellar ataxia (SCA) who was taking high-dose amantadine. He was admitted to hospital for an acute worsening of chronic dysphagia—difficulty swallowing—due to progression of SCA.
His oral medications were held because of his swallowing difficulty. Four days later, he developed fever, tachycardia (a rapid heart rate) and mild rigidity in his extremities, and became obtunded, meaning his alertness was markedly reduced. Despite antibiotic treatment, the changes in his vital signs and mental status persisted for 8 days.
When amantadine was resumed, his vital signs and encephalopathy improved within 2 days. The authors describe this as among the first reports of amantadine withdrawal syndrome (AWS) in a patient without Parkinson's disease.
They conclude that the case reinforces the importance of careful medication review at admission and considering pharmacologic side effects not only when medications are started, but also when they are discontinued.
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