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Neurology (Expert Forum)
Neurontin/Ultram/Porphyria?
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury.
Neurontin/Ultram/Porphyria?
by De__0__0, Oct 13, 1998 12:00AM
My doctor had me abruptly stop 900mg a day of Neurontin I had been on for two months for nerve pain as it didn't help. I was not weaned off. Two days later took a tab of Ultram and couldn't talk, walk, or get up. Was sick for days after with acute nausea, abdominal pain, dizziness.
Now my doctor thinks because I have Sensory PN and these pain medications didn't work that I have Porphyria? I have no family history of such a thing? Could it be taking Ultram after abruptly stopping the other medication caused the adverse reaction? or do people with sensory PN have Porphyria? Should I be concerned?
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Thanks for your question. Porphyria can present with symptoms including
severe abdominal pain, vomiting, constipation, hypertension, tachycardia,
and bladder dysfunction. These symptoms have been ascribed to autonomic
neuropathy. Other symptoms are motor weakness and sensory involvement,
which correlate with peripheral axonal neuropathy, and mental symptoms
occurring without clear morphological findings in the cerebrum. The
pathogenetic mechanisms which lead to the neurological dysfunction have
remained poorly understood. Neurontin is the anti-epileptic of choice
when a patient presents with porphyria, because this medication is NOT
metabolized in the liver. It is unlikely that either introduction or
withdraw from Neurontin would result in porphyria. A clinical literature
survey over the last 10 years did not show any reports of tramadol (Ultram)-
induced porphyria, but this is a relatively new medication. I included
a few review articles in the subject of neuropathies and porphyria. These
articles were not intended, and were not written in layman's terms, but
they can be read with some effort, and they can be found in any good
university library:
Porphyric neuropathy: a clinical, neurophysiological and morphological study.
Ital J Neurol Sci 1985 Dec;6(4):521-6 (ISSN: 0392-0461)
Defanti CA; Sghirlanzoni A; Bottacchi E; Peluchetti D
Autonomic neuropathy in acute intermittent porphyria.
J Neurol Neurosurg Psychiatry 1985 Oct;48(10):1025-30 (ISSN: 0022-3050)
Laiwah AC; Macphee GJ; Boyle P; Moore MR; Goldberg A
Acute porphyrias: pathogenesis of neurological manifestations.
Semin Liver Dis 1998;18(1):43-52 (ISSN: 0272-8087)
Meyer UA; Schuurmans MM; Lindberg RL
I hope this information is helpful. Best of luck.
This information is provided for general medical education purposes only.
Please consult your doctor regarding diagnostic and treatment options.
