Gabapentin-Induced Adrenal Insufficiency: The Hypothalamic-Pituitary-Adrenal Axis Stress Misresponse and Risk of Infection: A Case Report and Literature Review

This literature review, in light of the presented case report, explores the complex interplay between gabapentin (GBP), a gamma-aminobutyric acid (GABA) analog, and the hypothalamic–pituitary–adrenal (HPA) axis in patients undergoing major surgical procedures. It specifically investigates the potent...

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Main Authors: Evmorfia Pechlivanidou, Alexandros Chatzikyriakos, Maria Anna Zisi, Nikolaos Paraskevopoulos, Semeli Kaltsa, Orestis K. Konstantas, Panteleimon Zogakis, Aikaterini Catsouli, Nick Sekouris, Rodanthi E. Margariti
Format: Article
Language:English
Published: MDPI AG 2024-09-01
Series:Pharmaceuticals
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Online Access:https://www.mdpi.com/1424-8247/17/9/1174
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author Evmorfia Pechlivanidou
Alexandros Chatzikyriakos
Maria Anna Zisi
Nikolaos Paraskevopoulos
Semeli Kaltsa
Orestis K. Konstantas
Panteleimon Zogakis
Aikaterini Catsouli
Nick Sekouris
Rodanthi E. Margariti
author_facet Evmorfia Pechlivanidou
Alexandros Chatzikyriakos
Maria Anna Zisi
Nikolaos Paraskevopoulos
Semeli Kaltsa
Orestis K. Konstantas
Panteleimon Zogakis
Aikaterini Catsouli
Nick Sekouris
Rodanthi E. Margariti
author_sort Evmorfia Pechlivanidou
collection DOAJ
description This literature review, in light of the presented case report, explores the complex interplay between gabapentin (GBP), a gamma-aminobutyric acid (GABA) analog, and the hypothalamic–pituitary–adrenal (HPA) axis in patients undergoing major surgical procedures. It specifically investigates the potential impact of GBP on cortisol levels, stress responses, and infection risk, illustrated by a detailed clinical case. This review combines a comprehensive literature search with a case report of a 17-year-old male with osteosarcoma who experienced transient adrenal insufficiency and infections while receiving GBP. The case is analyzed in the context of the existing literature on GBP and the HPA axis. The findings highlight the intricate relationship between GBP use, adrenal insufficiency, and infection susceptibility. It underscores the need for further research and clinical vigilance when prescribing GBP to patients with underlying medical conditions, particularly in the context of major surgical procedures. The review underscores the need for further research and clinical vigilance when prescribing GBP, particularly in perioperative settings. In conclusion, GBP’s effects on the HPA axis and immune responses are complex and multifaceted. Clinicians should exercise caution when prescribing GBP, especially for patients with underlying conditions undergoing major surgery. Further research is needed to elucidate the mechanisms of GBP’s influence on cortisol levels and stress responses.
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spelling doaj-art-5bcf3afb3c1749ae8dd8b8c85f5d5db22025-08-20T01:55:46ZengMDPI AGPharmaceuticals1424-82472024-09-01179117410.3390/ph17091174Gabapentin-Induced Adrenal Insufficiency: The Hypothalamic-Pituitary-Adrenal Axis Stress Misresponse and Risk of Infection: A Case Report and Literature ReviewEvmorfia Pechlivanidou0Alexandros Chatzikyriakos1Maria Anna Zisi2Nikolaos Paraskevopoulos3Semeli Kaltsa4Orestis K. Konstantas5Panteleimon Zogakis6Aikaterini Catsouli7Nick Sekouris8Rodanthi E. Margariti91st Department of Orthopaedics, P. & A. Kyriakou Children’s Hospital, 115 27 Athens, Greece1st Department of Orthopaedics, P. & A. Kyriakou Children’s Hospital, 115 27 Athens, GreeceMedical School, National and Kapodistrian University of Athens, 157 72 Athens, Greece1st Department of Orthopaedics, P. & A. Kyriakou Children’s Hospital, 115 27 Athens, Greece1st Department of Orthopaedics, P. & A. Kyriakou Children’s Hospital, 115 27 Athens, Greece1st Department of Orthopaedics, P. & A. Kyriakou Children’s Hospital, 115 27 Athens, Greece1st Department of Orthopaedics, P. & A. Kyriakou Children’s Hospital, 115 27 Athens, Greece1st Department of Orthopaedics, P. & A. Kyriakou Children’s Hospital, 115 27 Athens, Greece1st Department of Orthopaedics, P. & A. Kyriakou Children’s Hospital, 115 27 Athens, Greece1st Department of Orthopaedics, P. & A. Kyriakou Children’s Hospital, 115 27 Athens, GreeceThis literature review, in light of the presented case report, explores the complex interplay between gabapentin (GBP), a gamma-aminobutyric acid (GABA) analog, and the hypothalamic–pituitary–adrenal (HPA) axis in patients undergoing major surgical procedures. It specifically investigates the potential impact of GBP on cortisol levels, stress responses, and infection risk, illustrated by a detailed clinical case. This review combines a comprehensive literature search with a case report of a 17-year-old male with osteosarcoma who experienced transient adrenal insufficiency and infections while receiving GBP. The case is analyzed in the context of the existing literature on GBP and the HPA axis. The findings highlight the intricate relationship between GBP use, adrenal insufficiency, and infection susceptibility. It underscores the need for further research and clinical vigilance when prescribing GBP to patients with underlying medical conditions, particularly in the context of major surgical procedures. The review underscores the need for further research and clinical vigilance when prescribing GBP, particularly in perioperative settings. In conclusion, GBP’s effects on the HPA axis and immune responses are complex and multifaceted. Clinicians should exercise caution when prescribing GBP, especially for patients with underlying conditions undergoing major surgery. Further research is needed to elucidate the mechanisms of GBP’s influence on cortisol levels and stress responses.https://www.mdpi.com/1424-8247/17/9/1174gabapentinadrenal insufficiencyinfectionsHPA axisstress responses<i>Staphylococcus xylosus</i>
spellingShingle Evmorfia Pechlivanidou
Alexandros Chatzikyriakos
Maria Anna Zisi
Nikolaos Paraskevopoulos
Semeli Kaltsa
Orestis K. Konstantas
Panteleimon Zogakis
Aikaterini Catsouli
Nick Sekouris
Rodanthi E. Margariti
Gabapentin-Induced Adrenal Insufficiency: The Hypothalamic-Pituitary-Adrenal Axis Stress Misresponse and Risk of Infection: A Case Report and Literature Review
Pharmaceuticals
gabapentin
adrenal insufficiency
infections
HPA axis
stress responses
<i>Staphylococcus xylosus</i>
title Gabapentin-Induced Adrenal Insufficiency: The Hypothalamic-Pituitary-Adrenal Axis Stress Misresponse and Risk of Infection: A Case Report and Literature Review
title_full Gabapentin-Induced Adrenal Insufficiency: The Hypothalamic-Pituitary-Adrenal Axis Stress Misresponse and Risk of Infection: A Case Report and Literature Review
title_fullStr Gabapentin-Induced Adrenal Insufficiency: The Hypothalamic-Pituitary-Adrenal Axis Stress Misresponse and Risk of Infection: A Case Report and Literature Review
title_full_unstemmed Gabapentin-Induced Adrenal Insufficiency: The Hypothalamic-Pituitary-Adrenal Axis Stress Misresponse and Risk of Infection: A Case Report and Literature Review
title_short Gabapentin-Induced Adrenal Insufficiency: The Hypothalamic-Pituitary-Adrenal Axis Stress Misresponse and Risk of Infection: A Case Report and Literature Review
title_sort gabapentin induced adrenal insufficiency the hypothalamic pituitary adrenal axis stress misresponse and risk of infection a case report and literature review
topic gabapentin
adrenal insufficiency
infections
HPA axis
stress responses
<i>Staphylococcus xylosus</i>
url https://www.mdpi.com/1424-8247/17/9/1174
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