Psychotic Decompensation During Nalmefene Treatment in a Patient With Schizoaffective Disorder: A Case Report

Abstract

Objective: Nalmefene is a kappa-opioid receptor agonist/antagonist which is currently prescribed to reduce heavy drinking days. Adverse events (AEs) have previously been described in trials, but these trials excluded patients with psychiatric comorbidities. This is important as psychiatric disorders are frequently associated with alcohol use disorders; therefore, the specific AEs in this population should be investigated. Methods: Here, we describe the case of a patient with diagnosed alcohol use disorder and schizoaffective disorder who received treatment with nalmefene. Results: The patient showed decompensation of psychotic symptoms after two doses of medication, consisting of auditory hallucinations, delusions, and ideas of persecution. The symptoms improved two days after treatment discontinuation. Conclusions: This case indicates that the AEs of nalmefene should be specifically investigated in patients with psychiatric disorders.

Keywords:

• Nalmefene
• psychotic decompensation
• adverse event

Acknowledgments

We would like to show our gratitude to the reviewers for their comments that improved the manuscript.

Disclosure statement

The authors report no financial relationships with commercial interests.

Author contributions

JS recruited the patient; JS, LS, and CP wrote the case report and conducted the literature search.