en
Scientific article
Case report
Open access
English

Case Report: Opioid Use Disorder Associated With Low/Moderate Dose of Loperamide in an Intellectual Disability Patient With CYP3A and P-Glycoprotein Reduced Activity

Published inFrontiers in psychiatry, vol. 13, 910684
Publication date2022-06-23
First online date2022-06-23
Abstract

Loperamide is an over-the-counter antidiarrheal for which increasing cases of abuse or misuse are described. We report the onset of opioid use disorder associated with low to moderate doses of loperamide in an intellectual disability patient without previous history of substance use disorder (SUD). Our patient presented strongly reduced activities of CYP3A and P-glycoprotein, which are mainly involved in loperamide metabolism and transport. We suggest that this led to an increase in bioavailability, systemic exposure, and brain penetration thus allowing loperamide to act on the central nervous system and contributing to the development of SUD. Slow release oral morphine (SROM) was chosen as opioid agonist treatment, which successfully contained loperamide use and globally improved her clinical condition. This situation highlights the need for caution and awareness when prescribing loperamide, particularly in vulnerable patients with few cognitive resources to understand the risks of self-medication and little insight into its effects.

eng
Keywords
  • P-glycoprotein
  • Case report
  • Cytochrome P450
  • Intellectual disability
  • Loperamide
  • Opioid use disorder
Citation (ISO format)
GUINCHAT, Vincent et al. Case Report: Opioid Use Disorder Associated With Low/Moderate Dose of Loperamide in an Intellectual Disability Patient With CYP3A and P-Glycoprotein Reduced Activity. In: Frontiers in psychiatry, 2022, vol. 13, p. 910684. doi: 10.3389/fpsyt.2022.910684
Main files (1)
Article (Published version)
Identifiers
ISSN of the journal1664-0640
10views
2downloads

Technical informations

Creation04/11/2024 9:15:34 PM
First validation05/03/2024 1:42:46 PM
Update time05/03/2024 1:42:46 PM
Status update05/03/2024 1:42:46 PM
Last indexation05/03/2024 1:43:07 PM
All rights reserved by Archive ouverte UNIGE and the University of GenevaunigeBlack