Document Type: Case Report(s)
Professor, Department of Psychiatry, School of Medicine AND Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
Resident, Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
Background: Loperamide is used as an antidiarrheal drug and is available over-the-counter. It cannot pass the blood-brain barrier and it does not have a considerable abuse potential. It can lead to dangerous cardiac arrhythmia.Case Report: Herein, we report a 35-year-old man with a 13-year history of abusing opioids who had undergone detoxification for four times during this period. He underwent detoxification for using 200 mg loperamide daily with anticholinergic agents, clonidine, non-steroidal analgesics, and diazepam. No evidence of arrhythmia was seen in the patient.Conclusion: Tolerating high doses of loperamide could be dangerous and increases the risk of fatal cardiac arrhythmias.
- Spinner HL, Lonardo NW, Mulamalla R, Stehlik J. Ventricular tachycardia associated with high-dose chronic loperamide use. Pharmacotherapy 2015; 35(2): 234-8.
- Regnard C, Twycross R, Mihalyo M, Wilcock A. Loperamide. J Pain Symptom Manage 2011; 42(2): 319-23.
- Lexicomp Online. Loperamide Hydrochloride Oral-Facts and Comparisons eAnswers [online]. [cited 2014 Jul]; Available from: URL: http://qnf.qa/lco/action/doc/retrieve/docid/fc_dfc/5549583
- Friedli G, Haenggeli CA. Loperamide overdose managed by naloxone. Lancet 1980; 1(8183): 1413.
- Marraffa JM, Holland MG, Sullivan RW, Morgan BW, Oakes JA, Wiegand TJ, et al. Cardiac conduction disturbance after loperamide abuse. Clin Toxicol (Phila) 2014; 52(9): 952-7.
- Drugs. Loperamide dosage [Online]. [cited 2015 Mar 31]; Available from: URL: https://www.drugs.com/dosage/loperamide.html
- Drug Forum. Recommended loperamide dosage for withdrawal? [Online]. [cited 2015 Mar 31]; Available from: URL: https://drugs-forum.com/threads/recommended-loperamide-dosage-for-withdrawal.172179/
- Daniulaityte R, Carlson R, Falck R, Cameron D, Perera S, Chen L, et al. "I just wanted to tell you that loperamide WILL WORK": a web-based study of extra-medical use of loperamide. Drug Alcohol Depend 2013; 130(1-3): 241-4.
- Lavin MR. Misuse of loperamide in anxiety disorder patients. Depress Anxiety 1996; 4(5): 254-5.
- Langlitz N, Schotte K, Bschor T. Loperamide abuse in anxiety disorder. Nervenarzt 2001; 72(7): 562-4. [In German].