Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Under suspicion: the painkiller ziconotide could increase suicidal ideation

23.11.2010
Experts recommend more precise diagnosis and closer medical surveillance / RUB pharmacists issue a warning in “PAIN”

The active agent ziconotide, the synthetic toxin of the cone snail (Conus magus), was acclaimed a safe alternative to morphine when it was introduced six years ago. Now it is increasingly suspected of causing patients to commit suicide. Researchers working under the auspices of Prof. Christoph Maier (Director of the Pain Clinic Bergmannsheil at the Ruhr University in Bochum) presume that ziconotide not only suppresses the transmission of pain stimuli, but also deteriorates the frame of mind and could simultaneously reduce anxiety and impulse control.

These mechanisms could promote suicidal tendencies in vulnerable patients. The research scientists thus advise careful diagnosis and monitoring of the psychic condition of patients treated with ziconotide. They have published their findings in the Medical Journal “PAIN.”

Alternative to opioids for severe pain

Ziconotide has numerous advantages, including the fact that it does not have any of the side effects typically associated with opioids, such as respiratory depression (asphyxia). Moreover, it does not lead to tolerance development. It has been on the European and American market since 2004, being administered to patients with intrathecal pumps if opioids do not suffice or if these trigger inacceptable side effects. Recently, the number of reports on the psychic side effects of ziconotide has increased. The researchers in Bochum analysed numerous studies, registering an increasing number of attempted suicides, which the original authors had not attributed to the ziconotide treatment. In PAIN, the physicians from RUB present two new cases, which underscore the suspicion that ziconotide enhances suicidal ideation.

Suicide despite pain relief and normal test results

As Prof. Maier stated, the first case is particularly tragic, the patient concerned, who had had pain is his feet for many years and undergone numerous unsuccessful treatments, having experienced a distinct improvement and pain relief for the first time when treated with ziconotide. There were no side effects. Tests disclosed that his depressiveness, which had also not been particularly marked before the ziconotide treatment commenced, even decreased. After a good three weeks, he appeared to be happy to all concerned. But two months after the ziconotide treatment had commenced he unexpectedly committed suicide. A further patient, a 39-year-old woman, who had undergone pain treatment for backache for 14 years, had had depressive phases 20 years previously and had attempted suicide after a pregnancy. Two months after the ziconotide treatment had commenced – which, according to current recommendations, should never have been administered to her in the first place due to her medical history – she mentioned that she had increased suicidal ideation. Moreover, she complained of other psychic side effects with hallucinations, confusion and partial amnesia, which had resulted in two severe car accidents. It is conceivable that the accidents were also of suicidal character. The physicians stopped the ziconotide treatment. Two weeks later both the suicidal ideation and the hallucinations were history.

Pharmaceutical companies and approval authorities must investigate the situation

Prof. Maier concludes that both cases underscore the assumption that there is a causality between ziconotide and suicidal tendencies. The pain specialist strongly emphasizes that the pharmaceutical companies and approval authorities should urgently investigate this yet again. All patients must be analysed for possible psychic disorders before treatment commences and closely monitored irrespective of pain relief due to the drug. The above-mentioned cases also underscore the fact that an increase in pain treatment when standard drugs fail is not always the correct mode of action. As Prof. Maier so aptly said, it is often even exactly the wrong path. This had already been pointed out a few weeks previously at the Congress of the German Pain Therapists (Kongress der deutschen Schmerztherapeuten)

Title

Christoph Maier, Hans-Helmut Gockel, Kai Gruhn, Elena K. Krumova and Marc-Andreas Edel: Increased risk of suicide under intrathecal ziconotide treatment? – A warning. In: PAIN, online 1.11.2010, doi:10.1016/j.pain.2010.10.007, http://www.painjournalonline.com/article/S0304-3959%2810%2900615-9/abstract

Further Information

Prof. Dr. Christoph Maier, Leiter der Schmerzklinik des RUB-Klinikums Bergmannsheil, Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Tel. +49(0)234/302-6366, E-Mail: christoph.maier@rub.de

Editor: Meike Drießen

Dr. Josef König | idw
Further information:
http://www.ruhr-uni-bochum.de/
http://www.painjournalonline.com/article/S0304-3959%2810%2900615-9/abstract

More articles from Health and Medicine:

nachricht Study suggests possible new target for treating and preventing Alzheimer's
02.12.2016 | Oregon Health & Science University

nachricht The first analysis of Ewing's sarcoma methyloma opens doors to new treatments
01.12.2016 | IDIBELL-Bellvitge Biomedical Research Institute

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Novel silicon etching technique crafts 3-D gradient refractive index micro-optics

A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.

Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...

Im Focus: Quantum Particles Form Droplets

In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.

“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...

Im Focus: MADMAX: Max Planck Institute for Physics takes up axion research

The Max Planck Institute for Physics (MPP) is opening up a new research field. A workshop from November 21 - 22, 2016 will mark the start of activities for an innovative axion experiment. Axions are still only purely hypothetical particles. Their detection could solve two fundamental problems in particle physics: What dark matter consists of and why it has not yet been possible to directly observe a CP violation for the strong interaction.

The “MADMAX” project is the MPP’s commitment to axion research. Axions are so far only a theoretical prediction and are difficult to detect: on the one hand,...

Im Focus: Molecules change shape when wet

Broadband rotational spectroscopy unravels structural reshaping of isolated molecules in the gas phase to accommodate water

In two recent publications in the Journal of Chemical Physics and in the Journal of Physical Chemistry Letters, researchers around Melanie Schnell from the Max...

Im Focus: Fraunhofer ISE Develops Highly Compact, High Frequency DC/DC Converter for Aviation

The efficiency of power electronic systems is not solely dependent on electrical efficiency but also on weight, for example, in mobile systems. When the weight of relevant components and devices in airplanes, for instance, is reduced, fuel savings can be achieved and correspondingly greenhouse gas emissions decreased. New materials and components based on gallium nitride (GaN) can help to reduce weight and increase the efficiency. With these new materials, power electronic switches can be operated at higher switching frequency, resulting in higher power density and lower material costs.

Researchers at the Fraunhofer Institute for Solar Energy Systems ISE together with partners have investigated how these materials can be used to make power...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

ICTM Conference 2017: Production technology for turbomachine manufacturing of the future

16.11.2016 | Event News

Innovation Day Laser Technology – Laser Additive Manufacturing

01.11.2016 | Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

 
Latest News

UTSA study describes new minimally invasive device to treat cancer and other illnesses

02.12.2016 | Medical Engineering

Plasma-zapping process could yield trans fat-free soybean oil product

02.12.2016 | Agricultural and Forestry Science

What do Netflix, Google and planetary systems have in common?

02.12.2016 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>