• Pain management · May 2017

    Case Reports

    Rare presentation of intrathecal morphine withdrawal psychosis.

    • Rohit Aiyer, Vivek Jain, Anurag Bhatia, Boris Mekinulov, and Semih Gungor.
    • Department of Psychiatry, Hofstra Northwell Health - Staten Island University Hospital, Staten Island, NY, USA.
    • Pain Manag. 2017 May 1; 7 (3): 171-173.

    AbstractWe report a case of a 57-year-old male patient with intrathecal morphine pump failure who presented with psychosis as part of a clinical presentation of opioid withdrawal. The patient was being treated for chronic back pain with an intrathecal morphine pump for several years. The patient spontaneously started to experience psychotic symptoms which included disorganized thinking, delusional thoughts, paranoia, auditory and visual hallucinations. Upon interrogation of intrathecal pump, it was found not to be functioning, thereby not delivering intrathecal morphine. After opioid rotation with administration of oral oxycodone, the patient's psychosis improved dramatically within a few days, clinically confirming psychosis due to morphine withdrawal. Therefore, it is important for physicians to consider opioid withdrawal in patients experiencing isolated psychosis.

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