Die Rehabilitation
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Case Reports
[Chronic dizziness in a pain patient--pharmacogenomic identification of tramadol as cause].
This casuistic reports on a 59-year-old pain patient taking normal dosage Tramadol as analgetic drug, who suffered from chronic dizziness leading to immobilisation for more than 9 months. On admission to inpatient rehabilitation Tramadol was removed in exchange for morphine sulphate with the unexpected result of a prompt and lasting stop of dizziness. A molecular-genetic investigation showed a duplication in the CYP2D6 gene. ⋯ Under morphine sulphate which is metabolized independently of CYP2D6, a sufficient analgetic outcome could be achieved. Dizziness did not appear in the patient any longer, and he could be mobilised during rehabilitation. Pharmacogenomic knowledge has helped develop a sustainable concept for rehabilitation of this seriously ill patient, and to put it into practise successfully.