Abstract
We report two patients on hemodialysis in whom a single dose of γ-aminobutyrate (GABA) analogues caused muscle weakness of the lower extremities. Both patients had a history of long-term hemodialysis for 23 and 31 years, respectively. They used benzodiazepine receptor stimulants for insomnia and complained of neuralgia caused by spinal canal stenosis. A single administration of either pregabalin (25mg) or gabapentin (200mg) provoked muscle weakness of the lower extremities and gait disturbance, and no pain relief was obtained. The adverse effect of these agents had completely resolved the next day without receiving hemodialysis. GABA analogues should be cautiously administered to anuric patients on long-term hemodialysis who receive drugs that augment the effects of GABA analogues.
