Lofepramine First report of motor neuron disorders in an elderly patient: case report

* After an 18-month history of

lethargy, agitation and weight loss an 84-year-old woman , with a strong family history of depressive illness, was admitted. She appeared cachectic , with pronounced psychomotor retardation , and had delusions of nihilism and poverty. Depressive illness was diagnosed.

The patient received lofepramine 70mg bid , increased to 70mg tid after 9 days without response.

After 1 month of lofepramine therapy, the patient developed a high stepping gail. She was unable to dorsiflex her feel. Lofepramine therapy was withdrawn . Eight weeks later, the patient's mental state was unchanged but her footdrop improved and her gait was no longer high stepping .

'Although It Is difficult to attribute this woman's motor neuropathy directly to lofepramlne, we draw attention to a previously unreported potential side effect of this drug,'

Hewitt JA, Glinn J. Lofrepamine and motor neuropathy. British Medical Journal 299: 1223·1224, 11 Nov 1989 623